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Review
. 2019 Nov 27:13:2317-2323.
doi: 10.2147/OPTH.S205148. eCollection 2019.

Intraocular Lens Implantation In The Ciliary Sulcus: Challenges And Risks

Rajvi Mehta  1 , Ahmad A Aref  1
Affiliations
Review

Intraocular Lens Implantation In The Ciliary Sulcus: Challenges And Risks

Rajvi Mehta et al. Clin Ophthalmol. .

Abstract

Purpose: This article reviews the current literature on the risks and challenges associated with intraocular lens (IOL) implantation in the ciliary sulcus.

Recent findings: The development of IOLs designed specifically for placement in the ciliary sulcus continues to be an area of interest for the ophthalmic industry. Currently the one-piece PMMA (polymethylmethacrylate) lens or a three-piece IOL are the best available options for IOL placement in the ciliary sulcus space. Single piece acrylic (SPA) IOLs are not designed for sulcus placement and there is growing evidence of chronic complications related to their use in the ciliary sulcus. Many of these eyes ultimately require surgical intervention, including lens exchange. Endoscopic imaging and ultrasound biomicroscopy (UBM) have enabled a better understanding of ciliary sulcus anatomy and measurements in the living eye.

Summary: When the capsular bag is compromised, IOL placement in the ciliary sulcus is a reasonable option. In these circumstances, appropriate choice of IOL, knowledge of the sulcus anatomy, and correct technique can improve results and reduce postoperative complications.

Keywords: capsule rupture; ciliary sulcus; complications; intraocular lens; surgical technique.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Anatomical measurements and landmarks based on UBM imaging. A (angle of the ciliary sulcus) = 66.3 degrees, the distance from CD to CP = 0.535mm, the length of a perpendicular line drawn from CD to the sclera = 1.52mm, and the length of a line drawn parallel to the posterior iris surface from CD to the sclera = 2.48mm.
Figure 2
Figure 2
High-frequency ultrasound biomicroscopic image demonstrating a well positioned 3-piece intraocular lens in the ciliary sulcus space.
Figure 3
Figure 3
Slit-lamp photograph demonstrating the presence of a 1-piece acrylic intraocular lens in the ciliary sulcus space, resting on the anterior capsule. Mechanical iris chafing caused by the malpositioned intraocular lens resulted in pigmentary glaucoma that required aqueous shunt implantation.
See this image and copyright information in PMC

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