EW CATARACT
69
that investigated the complications
associated with this fixation tech-
nique in 208 eyes in 185 patients
showed minimal intraoperative
complications: 0.4% hyphema,
0.4% haptic breakage, 1% deformed
haptics; early complications includ-
ing 6% corneal edema, 2% epithelial
defect, and 2.5% AC reaction (grade
2); and late complications like 4.3%
optic capture, 3.3% haptic decentra-
tion, 2% haptic extrusion, and 1.4%
subconjunctival haptic, after a mean
17-month follow-up.
2
The right IOL can greatly affect
outcome stability as can the right
surgical technique. "My go-to IOL
for scleral tunnel fixation is the
Aaris EC-3 PAL [Carl Zeiss Meditec,
Jena, Germany]," Dr. Garg said. "Its
6% of patients and suture exposure
in 11% at the 5-year time point.
1
Scleral tunnel/glued IOLs, on the
other hand, have minimal phaco-
donesis, as demonstrated on high
speed videography of IOLs secured
through scleral tunnel fixation.
Complications
From the surgical perspective, scleral
tunnel/glued haptic fixation has a
few drawbacks. It can be technically
difficult, involving a long learning
curve, is most easily done with an
assistant, which is not available to
all surgeons, and requires specific
instrumentation, including coaxial
micro-instruments for the anteri-
or segment, an anterior chamber
maintainer, and fibrin glue. A study
Tunnel haptics into sclerotomies
Appearance at end of case with conjunctiva glued into place
Source: Sam Garg, MD
continued on page 70
