Iris-Sutured Posterior Chamber Lens Dislocation Late After Penetrating Keratoplasty

Intraocular lens placement in the absence of an intact posterior capsule presents a particular challenge to the surgeon. Many options are available: an open-loop anterior chamber lens can be used or a posterior chamber lens can be placed in the ciliary sulcus over residual capsular material or sutured either in the ciliary sulcus or to the posterior aspect of the iris. In the late 1980s, the method of choice at our institution during penetrating keratoplasty was to suture the lens to the posterior aspect of the iris. To evaluate the long-term stability of lenses that were fixed by this method, we reviewed the records of all of these operations performed in our institution over a 52-month period that were followed for at least 1 year.

A 7-mm optic, 3-piece posterior chamber intraocular lens with optic positioning holes was used in all the operations. A double-armed 10-0 polypropylene suture was passed