Anterior chamber intraocular lens, sutured posterior chamber intraocular lens, or glued intraocular lens: where do we stand?

PURPOSE OF REVIEW: To review the recent literature addressing the surgical approaches to intraocular lens (IOL) fixation in the setting of inadequate capsular support. RECENT FINDINGS: Lack of capsular support is a commonly encountered problem facing the anterior segment surgeon. Recent reports suggest that visual outcomes are generally good with modern IOLs and surgical approaches. More recently described techniques include sutureless scleral fixation and intraocular endoscopy-guided suture placement. SUMMARY: Many clinical circumstances require extracapsular IOL fixation and multiple options exist in the setting of inadequate capsular support. Ultimately, there are many factors that must be considered in selecting an appropriate surgical approach. These include ocular history as well as the skill, experience, and comfort level of the individual surgeon. The myriad of options that now exist for IOL fixation increases the likelihood that patients with a wide variety of pathologic states will attain their best possible visual outcome.

[Indications, terms and classification of reconstructive interventions based on penetrating keratoplasty with implantation of posterior chamber intraocular lens]. / Pokazaniia, sroki provedeniia i klassifikatsiia rekonstruktivnykh vmeshatel'stv na baze skvoznoi keratoplastiki s implantatsiei zadnekamernoi intraokuliarnoi linzy.

Based on analysis of 750 reconstructive operations on the anterior segment of the eye, the authors classify simultaneous reconstructive interventions based on perforating keratoplasty with implantation of posterior chamber intraocular lens (IOL). Indications, terms, and technological features of such operations are defined with due consideration for the etiology of involvement of the anterior segment of the eye, corneal status, presence of the lens, and intactness of the lenticular posterior capsule. Disk posterior chamber IOLs with intracapsular fixation are preferred (in case of an intact capsule sac, with suturing to the posterior surface of the cornea) in the absence of the posterior capsule of the lens. As a result of surgery, improvement of visual acuity by 0.04-0.8 was attained in 720 patients.