Transscleral fixation of a supplementary toric intraocular lens to prevent rotation in a pseudophakic patient.

A 61-year-old woman with a penetrating keratoplasty and a pseudophakic supplementary toric intraocular lens (IOL) (Sulcoflex toric 653T, ‒3.00 sphere and +5.50 cylinder) in the right eye presented to our practice multiple times for IOL realignment. The IOL's undulating haptics were designed for lens stability; however, lid forces and ovalization of the sulcus resulted in repeated anticlockwise rotation off the desired axis. The IOL was therefore sutured transsclerally to maintain axis orientation at 20 degrees. The postoperative refraction was +0.50 -1.00 × 76 with visual acuity of 20/25. Transscleral fixation of a supplementary IOL in an eye with a previous corneal graft is described. This procedure can result in stabilization of a pseudophakic supplementary toric IOL with good visual rehabilitation.