This is an unusual case of prior trauma. A 13 year old boy was playing with fireworks and sustained a severe ocular injury which resulted in a retinal detachment and dislocation of the crystalline lens. He underwent pars plana vitrectomy and lensectomy and has done well. He was using a contact lens to treat his aphakic but has become intolerant to it and he and his family now seek a surgical solution.
We are suturing a single-piece acrylic IOL to the sclera using GoreTex material, which is anticipated to last his lifetime. The IOL is foldable and is able to go through a 3-mm incision. The case went well and the patient recovered good vision. We aimed for a post-op goal of about -1 in order to match the refractive status of the opposite eye.
Click below to learn this technique of scleral IOL fixation:
Hi Dr. Devgan, I watched your Envista YouTube tutorial with great interest. You made it look so easy. I wanted to ask if you cut off the haptics of the IOL? I have been using Akreos but want to switch to Envista due to potential for opacification of the Akreos IOL. Also, how much distance (mm) between your radial sclerotomy sites? Thank you!
We left the haptics intact. About 1mm between the two entry sites. Very important to avoid over-tightening the sutures since they can cause a rip in the IOL fixation hole.