I. Howard Fine, MD

Stabilization of the decentered or subluxed IOL-capsular bag complex or implantation of a secondary posterior chamber IOL lacking capsular support can be accomplished by means of iris fixation and transscleral fixation through the ciliary sulcus or pars plana. Although iris fixation of decentered IOLs is a popular technique for lens stabilization, late onset of IOL-capsular bag complex subluxation resulting from zonular weakness or dialysis may be more easily repaired with scleral fixation.

Ophthalmologists must be familiar with the elements necessary for creating stable clear corneal incisions to provide the best care for patients after cataract and refractive surgery. Studies have shown that creating stable clear corneal incisions is important in preventing endophthalmitis.1-3

Bimanual microincision phacoemulsification at this time is similar to coaxial phaco in the mid-1980s. Critics said there was no reason to do phaco through a 3-mm incision when the incision had to be enlarged to 7 mm for IOL implantation.