Techniken und Ergebnisse der Implantation transskleral fixierter Hinterkammerlinsen in den Sulcus ciliaris

Temporary keratoprosthesis for transscleral fixation of posterior chamber intraocular lenses with penetrating keratoplasty

In the absence of zonular and capsular support, cataract surgeons increasingly prefer suture-fixated posterior chamber intraocular lenses (IOLs) to angle-supported anterior chamber lenses as a secondary IOL. Various suturing techniques have been proposed for fixating the posterior chamber IOL. Transscleral suture fixation appears advantageous but problematic when performed on an open globe. Moreover, excision of the vitreous base is impeded by the iris and the dark, unstable image. This article describes a technique that takes advantage of a temporary keratoprosthesis (TKP). When sutured onto the trephination opening, the TKP provides a bright, stable image and permits peripheral indentation of the globe, allowing for controlled, thorough vitrectomy. With the infusion pressure supplying adequate eye tone, ab externo transfixation, and thus a targeted passage of the sulcus, is possible. If the cornea permits transfixation, TKP may be used to tamponade after trephination and as a lens rest while the surgeon ties the sutures to the haptics.