Sutured IOL's to replace cataracts

March 28, 2018 — by William Goldstein
Tags: Iol S Intraocular Lens Laser Cataract Surgery


Intraocular lens implantation is an important procedure when it comes to laser cataract surgery. Essentially,
cataract is a cloudy and dense formation that develops on the natural lens of the eye, thus
impairing vision. Laser cataract surgery entails removing the part of the natural lens that is affected by
the cataract. Once the natural lens is removed, an intraocular lens is implanted within the lens
membrane to replace the natural lens and help the patient to see better.


What is scleral-fixated IOLs?


There are several different types of intraocular lens implants or IOLs, and one of them is called
scleral-fixated IOL.

Scleral IOLs are recommended in situations where the cornea is transplanted or in cases where
the iris offers insufficient support. Scleral fixation is also used in situations where the membrane
surrounding the lens is too weak or damaged. The IOL is sutured to the sclera of the eye. The sclera is a protective outer layer that is composed mainly of collagen and elastic fiber.

The procedure


While scleral-fixation appears to be a relatively simple procedure, it comes with certain
complications. The IOLs are implanted with the help of delicate sutures. It is fixed to two
different points on the sclera, namely the conjunctiva and the Tenon's capsule. The conjunctiva is the white part of the eye and it protects the sclera. The Tenon's capsule is a
thin membrance that covers the eyeball.

The sutures used to hold the IOL in place is relatively simply. There are, however, increased chances of complications such as conjunctival erosion. This is why scleral IOLs have to be sutured with precision and care. Another procedure for scleral fixation involves covering the lens with scleral flaps. The procedure starts with fashioning triangular shaped flaps. The flap is then positioned above the sclera and secured using a knot thus eliminating the need for sutures. Again, if the flap is too thin, it can tear or puncture. That is why the Flap needs to be designed with utmost precision.

Compared to the sutured scleral technique, the scleral flap is the most effective method of intraocular lens implantation. The only hitch is in designing the flap but it can be performed without much ado. Complications with this procedure are far less than that reported in cases where sutures are used. Results also show that the technique of using flaps allowed for better recovery post-op. The absence of sutures reduces irritation due to external exposure as well.