Trans-scleral plugs fixated IOL: a new paradigm for sutureless scleral fixation

To report the clinical outcomes of a new technique for transconjunctival intrascleral fixation of an intraocular lens (IOL).

We report a new surgical technique that uses biological glue to implant a posterior chamber intraocular lens (PC IOL) in eyes with a deficient or absent posterior capsule. Two partial-thickness limbal-based scleral flaps are made 180 degrees apart diagonally, and the haptics of the PC IOL are externalized to place them beneath the flaps. Fibrin glue is used to attach the haptics to the scleral bed, beneath the flap. This simple method of PC IOL implantation requires no specially designed haptics. It provides good flap closure and IOL centration and stability without suture-related complications.

We report a technique for sutureless fixation of standard 3-piece posterior chamber intraocular lenses (PC IOLs) in the ciliary sulcus in eyes without capsule support, which we have used in cases of subluxated and luxated cataract and for secondary IOL implantation. Fixation of the haptics in a limbus-parallel scleral tunnel allows exact centration and provides axial stability of the PC IOL to prevent distortion. The technique uses uncomplicated maneuvers for standard 3-piece PC IOL fixation without the need for special haptic architecture or preparation.