[Indications and techniques for scleral fixation and suturing of intraocular lenses to the posterior surface of the iris].

The concept of suturing posterior chamber lenses to the ciliary body and sclera as the preferred method for a primary or secondary implantation when there is no capsular or even iris support, particularly at the time of penetrating keratoplasty, was pioneered by Enrique Malbran, M.D., Director of the Malbran Ophthalmology Center in Buenos Aires, Argentina (the current President of the Pan American Association of Ophthalmology). The significant interest existing now with this type of procedure is due to the fact that there are a number of eyes being seen for penetrating keratoplasty where either intracapsular surgery or complicated extracapsular surgery was done and an anterior chamber lens implanted. Some of these eyes later developed corneal decompensation. At the time of penetrating keratoplasty it is in the benefit of these patients for the surgeon to place an intraocular lens into the posterior chamber, away from the endothelium of the graft. The long-term experience with such lenses--more than nine years--is very favorable.