gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Sutureless iris-fixed ciliary sulcus implantation of an especially designed posterior chamber IOL in aphakic eyes

Meeting Abstract

  • corresponding author P. Rieck - Dept. of Ohthalmology, Charité - Medical Faculty Berlin, Campus Virchow Klinikum, Berlin
  • H. Binder - Augenpraxis Dr. Binder, Obertshausen
  • O. Schwenn - Bürgerhospital, Frankfurt/Main
  • P. Kruse - Dept. of Ohthalmology, Charité - Medical Faculty Berlin, Campus Virchow Klinikum, Berlin
  • C. Hartmann - Dept. of Ohthalmology, Charité - Medical Faculty Berlin, Campus Virchow Klinikum, Berlin

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogSO.06.08

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Veröffentlicht: 22. September 2004

© 2004 Rieck et al.
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To avoid anterior chamber lens implantation in aphakic eyes without capsular or zonular support, the laborious scleral fixation of a standard posterior chamber IOL is widely used despite potential complications (macular edema, IOL tilt / decentration, suture erosion, vitreous hemorrhage). A sutureless iris-fixed ciliary sulcus implantation of a posterior chamber IOL (Binder-IOL, Fa. Iolution, Munich) designed especially for such cases represents an alternative.


At the end of both haptics of this IOL with a 6 mm optic zone, a T-shaped anchor is mounted at an angle of 45° from the optic plane. These anchors are inserted from behind the iris into peripheral iridotomies performed pre-op. with a YAG-laser or intra-op. with a vitrectomy cutter. The long, C-shaped haptics are thus secured in the ciliary sulcus.


After slight modification of the technique, the implantation can be performed securely and reproducible. In all 8 implantations performed up to now, the IOL was well centered and stable. A hyperemia of the iris vessels around the haptic anchor was noticed in the early pre-operative course. Later post-operatively, the iridotomies enlarged slightly. No further side effects have been observed.


Iris fixation of posterior chamber IOLs reveals less complications compared to scleral fixation. The methods of iris fixation so far (suture fixation or enclavation of an inversely implanted "phakic" lens) comes along with a marked anterior-posterior mobility of the IOL due to the loosened iris diaphragm in aphakic eyes. This complication has not been observed with the technique presented here. The required large incision still represents a disadvantage, however, a foldable type of this lens is currently developed.