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BLOG: Gluing the IOL beneath the cataract
Absence of capsular support poses a definite challenge to cataract surgeons in the intraoperative period, and the appropriate placement of an IOL in such a scenario is often a demanding situation. Moreover, there is often a risk of losing the cataractous lens or the nuclear material in the vitreous cavity.
In cases with a subluxated lens and lens coloboma, there is a communication between the anterior and posterior chambers from around the edges of the lenticular/zonular defect. In such a scenario, after doing a limited vitrectomy around the defect, a three-piece IOL is injected beneath the lens, and the haptics are externalized and tucked, as in a glued IOL procedure. The pre-placed IOL functions as an artificial posterior capsule and subsequently helps to emulsify the cataractous lens with the phacoemulsification probe. At this stage, narrowing down of the pupil is often helpful because it prevents the slippage of any lenticular material from around the edges of the IOL. This procedure has been described as glued IOL scaffold in the peer-reviewed literature, and the video attached with this blog demonstrates the technique.