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AbstractSO.12.04 Clinical results after implantation of a sutureless sulcus fixed posterior chamber IOLs in aphakic eyes without capsule Rieck P. W.1, Binder H.2
1Augenklinik, Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, 2Augenarztpraxis Dr. Binder, Olbertshausen Objective: An alternative to the complication-prone scleral fixation of a standard posterior chamber IOL in aphakic eyes without capsular support is a sutureless ciliary sulcus implantation of an especially designed posterior chamber IOL (Binder-IOL). First results of implantations of an PMMA model of this lens were encouraging, but a large tunnel preparation was necessary. Recently, a foldable version of this IOL has been developed (Binderflex).
Methods: In 14 eyes (6 already aphakic eyes with prior lentectomy due to trauma or primary lens subluxation, 8 eyes with additional IOL/capsular bag explantation because of IOL dislocation) we implanted a Binderflex-IOL. We evaluated intraoperative handling / problems as well as complications.
Results: The folded IOL can be safely implanted via a 3,4 mm tunnel. A clear cornea tunnel implantation is thus possible. The IOL reveals a high stability and is always perfectly centered. This IOL can thus be securely implanted in eyes with severely loosened iris diaphragm, thin iris stroma, traumatic mydriase or even partial iris defects. Postoperatively, a posterior position of the optic was noticed and afforded a modification of the hatics angulation. With the iridotomies performed too centrally a pupil ovalization may occur. In one case a transient cystoid macular edema became apparent. No further side effects have been observed.
Conclusions: Due to a stable sulcus fixation, the Binderflex-IOL is especialle suitable for eyes with severe mobility of the iris diaphragm, eg, after vitrectomy. The posterior localisation of the optic plane could be improved with a positive angulation of the haptics in the new version of the IOL. Since implantation of the haptic anchors is safe only with good visibility of the peripheral iris, the presence of peripheral corneal opacities should be carefully examined.
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