1775: the IOL is sitting on the macula

This patient suffered late dislocation of the IOL+capsular bag complex and it fell into the vitreous cavity and it now rests on the macula while the patient is supine. Certainly the patient will require a pars plana vitrectomy, but then what? How would you secure the IOL? Would you do an IOL exchange and then replace this IOL with a Yamane intra-scleral haptic fixated IOL or perhaps an iris claw lens? Our guest surgeon uses the four eyelets of this IOL to suture it to the sclera. We have previously shown this technique using two Gore-tex sutures, but in this case the surgeon chooses four 9-0 polypropylene sutures to suture each individual eyelet securely.

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