Capsule membrane suture fixation of decentered sulcus intraocular lenses.

Different surgical methods are used to fixate the subluxated sulcus intraocular lens (IOL) in the absence of in-bag fixation, ranging from iris and scleral suturing to optic capture of the IOL. A new technique, which we have termed capsule membrane suture fixation, provides an additional method for securing a subluxated or decentered sulcus-based IOL to the remnant capsule or a capsular membrane. This method can also be used in secondary surgery for fixation, repositioning, or removal and replacement of IOLs. In this technique, the IOL haptics are sutured to the fibrotic elements of the capsular membrane to center and secure the IOL to the capsular membrane and prevent complications associated with uveal touch.

Scleral fixation of a subluxated intraocular lens-capsular bag complex through a fibrotic continuous curvilinear capsulorhexis.

UNLABELLED: Several strategies have been devised to manage in-the-bag intraocular lens (IOL) subluxation. We describe a method of fixating the IOL-capsular bag complex to the sclera using the fibrotic ring that develops around the continuous curvilinear capsulorhexis (CCC). Two, preferably 3, double-armed 10-0 polypropylene sutures are passed around the fibrotic CCC rim of the capsule and out the Hoffman scleral pockets and then tied in the scleral tunnels to center the IOL-bag complex. This technique provides an alternative approach to repositioning and fixating the IOL-bag complex that is especially useful in cases in which removal and replacement of the IOL would be difficult. It also provides more than 2-point fixation to achieve perfect IOL centration. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.

Consequences of waiting for cataract surgery.

UNLABELLED: PURPOSE OR REVIEW: To conduct a concise review of primary research articles over the preceding year on the subject of the consequences of waiting for cataract surgery. RECENT FINDINGS: Waiting for cataract surgery beyond 6 months may result in increasing vision loss, decrease in quality life, loss of driver's license, depression and adverse events including falls and fractures. The consequences of waiting for cataract surgery not only affect patients, families and surgeons, but also health ministries and public health policy makers. Consequences are both quantitative and qualitative in nature, ranging from progressive vision loss to patients' decrease in quality of life from factors other than vision loss. Cataract wait lists are not unique to North America, and numerous international articles have described a broad variety of consequences. SUMMARY: Consequences of waiting for cataract surgery are multivariate in nature and easily extend beyond the clinical setting into sociodemographic realms and public health costs and policy arenas.