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ORIGINAL RESEARCH
Intraocular lens stitching to iris with full preservation of its functions: microreconstructive techniques
Pirogov Russian National Research Medical University, Moscow, Russia
Correspondence should be addressed: Khristo Periklovich Takhchidi
Volokolamskoe shosse, 30, korp. 2, Moscow, 123182, Russia; moc.liamg@1031tph
Compliance with ethical standards: the study was approved (Minutes #239 of April 15, 2024), and the patients voluntarily consented to surgical treatment and processing of personal data.
Today, implantation of an intraocular lens (IOL) into the capsular bag is the standard approach to surgical treatment of cataracts and aphakia of various origins. However, there are several reasons and conditions that disallow this operation or increase the risk of instability of the implanted lens, such reasons and conditions including weakness of the lens ligaments; degradation of Zinn's zonule, including dislocation of the IOL‒capsular bag complex post-surgery; damage to or removal of capsular bag during surgery; lack of capsular bag or its destruction during implantation in aphakia cases. To date, problems associated with fixation and centralization of IOL in non-standard cases involving weak or inexistent capsular support remain unresolved. This study aimed to develop techniques allowing to stitch IOL to the iris without compromising its functions in various situations when it is unfeasible or impossible to fix and center lens in the capsular bag. The patients (n = 12; 12 eyes), depending on the clinical situation, were divided into groups: group 1 — dislocations of the IOL–capsular bag complex (6 eyes); group 2 — complete lack of capsular support (3 eyes); group 3 — weakness of capsular support (3 eyes). A special stitching technique was developed for each of these situations. The results of the treatment were good from clinical and functional perspectives: the IOL was fixed securely and centered properly, and the iris's performance and cosmetic aspects were not compromised.
Keywords: lack or weakness of capsular support, IOL dislocation, destruction of lens ligaments, aphakia, avitria