In complicated cataract surgery, loosing zonular support, makes it difficult to implant an intraocular lens. In this instance, an intraocular lens needs to be inserted in the anterior chamber or fixated to the iris or the sclera.

Unlike scleral fixation, which is a complex procedure and is difficult to reproduce, iris-claw implants and anterior chamber implants are both easier to perform and tend to have a more reproducible final outcome. Fixating a lens to the iris, however, is still considered traumatising by some surgeons. That is why some surgeons would prefer to avoid iris-claw implants.

In the author’s view, anterior chamber IOL remains a good option. Historically, however, many AC implants have been used and led to side effects, most commonly endothelium damage, glaucoma and chronic cystoid macular oedema.

In the author’s experience, MT4 lens from Alcon has been a safe and easy lens to be implanted. It is a rigid IOL that does not cause endothelial touch and therefore minimises scarring and damage to the trabecular meshwork.

The author will present 30-year results of using this AC IOL while working as an associate with professor Jacques Libert.

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Cell Phone: +32496104081

Philippe Koch