Modified Peripheral Iris Fixation of a Foldable Intraocular Lens Following Phacoemulsification

In this report, we describe the case of an aphakic patient who underwent peripheral iris fixation of a foldable posterior chamber intraocular lens (IOL) in the absence of capsular support. The patient suffered from traumatic cataract with partial zonular dehiscence. He received phacoemulsification, and capsular rupture occurred subsequently. After complete anterior vitrectomy, the lens capsule disappeared completely. Six months later, secondary IOL implantation was performed. A clear corneal incision was made, and a paracentesis was created to insert a folded acrylic soft IOL and a temporary supporting device. The optic of a three-piece acrylic IOL was folded along the axis of the haptics, and both the haptics were bent and quickly maneuvered into the folded furrow of the optic. A bimanual unfolding maneuver created pupillary capture of the optic for stabilization and centration of the IOL, with the haptics expanding on the back surface of the iris, and the haptics were fixated to the peripheral iris with modified McCannel suturing. Fair visual outcome without complications was noted.