Background: To present a surgical technique using a rigid intraocular lens as endocapsular supporting device in manual small incision cataract surgery (MSICS) for treating mild-moderate subluxated cataracts.
Methods: In our technique, a single-piece rigid polymethyl methacrylate (PMMA) lens was implanted in the bag following the nucleus removal, with its axis vertical to the zonular dialysis. This endocapsular-implanted IOL stretched the bag and provided sufficient stability and lens centration. This technique was performed in 19 eyes with subluxated cataracts, with zonulysis of ≤120 degree and nuclear sclerosis of grade ≤3. Mean follow-up time was 9.8 months.
Results: All eyes had endocapsular IOL implantation during surgery. Intraoperative extension of the dialysis did not occur in any eye. The IOL was placed in the bag in all but 1 case, in which dislocation of the IOL haptic into the vitreous occurred. Though the IOL was slightly decentered in 3 cases, it kept stable. All patients were asymptomatic.
Conclusions: This approach provides a simplified and practical strategy for surgically managing subluxation with mild-moderate zonular loss.
Abstract: A smooth and timely fitting of a visually appealing, custom-made eye prosthesis after the loss of an eye is not only essential from a cosmetic point of view but above all facilitates good social and psychological rehabilitation. Cryolite glass prostheses must be replaced at least once a year, PMMA prostheses polished once a year and renewed every five years. In children, especially in growth phases, the fit of the prosthesis should be checked at least every six months and adjusted, if necessary. Ocularists and ophthalmologists should determine an individual cleaning procedure together with the patient, which depends on both the prosthesis material and external factors. Complications such as allergic, giant papillary, viral, and bacterial conjunctivitis or even blepharoconjunctivitis sicca must be detected and treated at an early stage to avoid discomfort and to maintain the ability of prosthesis wear. In the case of inflammation-induced shrinkage of the conjunctival fornices or post-enucleation socket syndrome, surgical interventions are necessary. In summary, an early supply with an eye prosthesis, adequate treatment of complications, and attention to psychological aspects, form the basis for a successful long-term rehabilitation of anophthalmic patients.
