Glued IOL a valuable technique for anterior segment surgeons

As cataract and refractive surgeons, we would ideally want the IOL to be well centered and positioned in the capsular bag. However, due to certain preoperative constraints or intraoperative issues, it might not always be possible to achieve this. If the capsular bag integrity is lost, then the choice of IOL depends on the extent of capsular support available, anterior chamber dimension, endothelial status, iris status, age of patient and, above all, the experience and expertise of the surgeons with a particular technique. The options available are an anterior chamber IOL, an iris clip/iris-fixated IOL and a scleral-fixated IOL, either sutured or glued. In case of zonular laxity, the extent of laxity determines the use of an endocapsular ring/segments with or without scleral fixation.Sutured scleral-fixated IOLs have been widely used over the last few decades with good surgical outcomes. However, the technique is technically challenging and time consuming. The associated complications, including IOL decentration, tilt and long-term suture degradation (unless 9-0 Prolene suture is used), contribute to suboptimal visual recovery.