A new technique for transscleral fixation of a posterior chamber intraocular lens in the absence of capsular support during penetrating keratoplasty.

In the setting of penetrating keratoplasty for the rehabilitation of aphakic or pseudophakic bullous keratopathy, a posterior chamber intraocular lens is frequently implanted in the absence of capsular support. Some surgeons have advocated transscleral fixation over iris fixation of the intraocular lens. Problems faced during such a procedure, however, include the obstructed approach of the suture needle behind the iris, and the exposed or eroded knot of the polypropylene suture. To circumvent both problems, we propose an ab externo technique that takes advantage of the work of Duffey et al and avoids the use of partial thickness scleral flaps.