Surgical techniques of intraocular lens-capsular bag complex stabilization during cataract phacoemulsification in patients with lens subluxation

Aim. To develop and to assess the efficacy of the method of one-step upper fixation of a single-piece intraocular lens to the iris during cataract phacoemulsification in patients with lens subluxation.

Methods. The study included 32 patients (37 eyes) with complicated cataract grade 2–3 combined with grade 1–2 lens subluxation. Both groups underwent cataract phacoemulsification with consequent implantation of a capsular tension ring and a single-piece intraocular lens. Group 1 (21 eyes) underwent intraoperative one-step upper haptic fixation of a single-piece intraocular lens in vertical position. In group 2 (16 eyes) in 13 cases 6±1.5 months later a single piece intraocular lens was repositioned and both haptics were sutured to the iris.

Results. In both groups no intraoperative complications occured. Visual acuity in group 1 on days 1–3 after the surgery was 0.77±0.19 and was stable during the follow-up. Intraocular pressure was 17.2±0.99 mm Hg. In group 2 the obtained good functional results 0.78±0.18 declined due to intraocular lens decentration, the intraocular pressure increased by 6.0±1.25 mm Hg (up to 24.2±0.65 mm Hg) which required an intraocular lens reposition in 81.3% of cases. According to ultrasound biomicroscopy, in both groups intraocular lens in all cases had intracapsular fixation and was in a central position.

Conclusion. The developed method of a one-step single piece intraocular lens fixation by suturing the upper haptic to the iris during cataract phacoemulsification in patients with lens subluxation is an effective and safe procedure that allows complete rehabilitation of patients with phacodonesis during a one-step surgical intervention.