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    Fibrin glue an option when capsular support is lacking

    San Diego—Fixating a posterior chamber IOL using fibrin glue is a “viable option in patients with deficient capsular support,” said Mahipal S. Sachdev, MBBS, MD.

    His group performed an interventional case series of 250 eyes (238 patients) that underwent glued IOL implantation for various indications, including traumatic subluxated cataracts, subluxated/ dislocated IOLs, and aphakia with absent posterior capsule. Follow-up was anywhere from 3 months to 3 years.

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    In this series, the majority of eyes (n = 95) presented with a subluxated IOL, and an additional 57 eyes presented with a subluxated lens, said Dr. Sachdev, of New Delhi, India.

    An IOL was placed in the eye and the haptics brought out through a sclerotomy created under scleral flaps made 180° away from each other and about 1 mm apart, he said.

    The IOL haptics were tucked into a scleral pocket “to prevent any sideward or up-down movement,” he said.

    This was reinforced with fibrin glue, and the scleral flaps were then repositioned and the conjunctiva closed with the same glue.

    In addition, at the time of surgery, associated complications, such as secondary glaucoma, corneal decompensation, corneal scars were treated with trabaeculectomy or valve implantation and penetrating keratoplasty or Descemet’s stripping endothelial keratoplasty (DSEK) as required.

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