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A small case series explored secondary intrascleral intraocular lens fixation in aphakic eyes with pseudoexfoliation syndrome after challenges with conventional capsular support. Three patients underwent a double-needle intrascleral fixation technique with preservation of the capsule where feasible. Good IOL fixation was achieved in all reported cases, and no serious complications such as retinal detachment or vitreous hemorrhage were observed during the reported follow-up. The value of this publication is less about proving superiority and more about illustrating a reconstructive option when zonular weakness prevents stable in-the-bag fixation. For surgeons encountering an aphakic eye after complicated cataract extraction, secondary IOL planning requires consideration of residual capsule, scleral integrity, iris anatomy, vitreous status, and surgeon familiarity with the fixation technique. Capsule-preserving strategies may help reduce vitreous prolapse and unwanted lens movement, but the authors appropriately emphasize that longer-term risks need further study. This makes the technique particularly relevant for advanced secondary-IOL instruction, where understanding decision pathways may be more important than memorizing a single fixation method.
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A small case series explored secondary intrascleral intraocular lens fixation in aphakic eyes with pseudoexfoliation syndrome after challenges with conventional capsular support. Three patients underwent a double-needle intrascleral fixation technique with preservation of the capsule where feasible. Good IOL fixation was achieved in all reported cases, and no serious complications such as retinal detachment or vitreous hemorrhage were observed during the reported follow-up. The value of this publication is less about proving superiority and more about illustrating a reconstructive option when zonular weakness prevents stable in-the-bag fixation. For surgeons encountering an aphakic eye after complicated cataract extraction, secondary IOL planning requires consideration of residual capsule, scleral integrity, iris anatomy, vitreous status, and surgeon familiarity with the fixation technique. Capsule-preserving strategies may help reduce vitreous prolapse and unwanted lens movement, but the authors appropriately emphasize that longer-term risks need further study. This makes the technique particularly relevant for advanced secondary-IOL instruction, where understanding decision pathways may be more important than memorizing a single fixation method.
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