This patient had trauma which resulted in a ruptured globe as you can see from the large corneal laceration which was previously repaired. The patient had a pars plana vitrectomy and lensectomy as well and is now aphakic. The corneal laceration has induced a large degree of corneal astigmatism which would be nicely offset with a toric IOL, however there is no capsular bag. How do you implant a toric IOL in this case? Our guest surgeon, Dr Abha Amin (from yesterday’s CataractCoach Podcast) uses the suture flange technique to secure a single-piece acrylic IOL to the sclera at the appropriate axis. But nothing comes easy as you will see when the toric IOL dangles in the vitreous cavity!
