Suven Bhattacharjee, MS, DO, DNB

A subluxated or unstable posterior chamber IOL needs to be repositioned and fixated to the sclera. This can often be a surgical challenge, and various surgical approaches have been described in the literature. Some of these techniques require a large limbal wound, with exteriorizing the IOL before it is repositioned and stabilized to the sclera. However, if for the most part such a procedure can be performed through small entry wounds, without the need for a larger limbal wound and without exteriorizing the entire IOL or exchanging the IOL, this will benefit the patient with less or no induced astigmatism and less chance of potential intraocular infection. It is important to secure the lens in a stable position in the posterior chamber, with the IOL haptics in the ciliary sulcus but away from the iris to prevent iris chafing, thus avoiding pigment dispersion, uveitis and secondary glaucoma.