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February 1988

New Optic Hole Configuration for Iris Fixation of Posterior Chamber Lenses

Arch Ophthalmol. 1988;106(2):163-164. doi:10.1001/archopht.1988.01060130173003

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To the Editor.  —Several authors have recently described their techniques for implanting posterior chamber intraocular lenses at the time of keratoplasty.1-4 Since I studied the original report by Hall and Muenzler,1 I have inserted posterior chamber lenses at the time of keratoplasty in nine patients with known or suspected anterior chamber angle compromise. My technique, derived from Hall and Muenzler, consists of suturing a four-hole optic lens to the iris with two double-armed 10-0 polypropylene sutures. Each suture passes through a pair of positioning holes and incorporates the overlying iris.For optic fixation, I believe that a four-hole optic provides distinct advantages over a two-hole optic. With the latter, only the small optic portion between the hole and optic edge is incorporated in the suture; therefore, only the small overlying iris segment can be used for lens fixation. The four-hole optic permits the surgeon to incorporate a broader

Hall JR, Muenzler WS:  Lens replacement in pseudophakic bullous keratopathy . Trans Ophthalmol Soc UK 1985;104:541-545.
Drews RC:  Posterior chamber lens implantation during keratoplasty without posterior lens capsule support . Cornea 1987;6:38-40.Article
Waring GO III:  Management of pseudophakic corneal edema with reconstruction of the anterior ocular segment . Arch Ophthalmol 1987;105:709-715.Article
Wong SK, Stark WJ, Gottsch JD, et al:  Use of posterior chamber lenses in pseudophakic bullous keratopathy . Arch Ophthalmol 1987;105:856-858.Article