Spider IOL



The authors aim to describe a surgical technique for management of eyes without adequate capsular support, by implantation of a four-haptic hydrophilic acrylic foldable intraocular lens (IOL), Bausch & Lomb AKREOS Adapt AO® with a transscleral knotless zigzag suture. Surgical technique consists in small gauge pars plana vitrectomy, small corneal incision (between 2,0 mm and 2,4 mm) for iOL implantation and transscleral zigzag suture of IOL without knot. The foldable haptic provides easy manipulation with low risk of damage, or other complications, such as haptic fracture which is not uncommon when these are made of PMMA. The small corneal incision prevents potencial intraoperative decompression of the globe and subsequent complications. Since the IOl is located in the sulcus, endothelial cell loss is lesser than with anterior chamber IOL. The 4 haptics of AKREOS Adapt AO® allow a stable position in the sulcus. This technique has good functional and anatomical results, with low or no induced astigmatism (small corneal incision), no erosion or trauma of the iris, no UGH syndrome (minimal IOL contact with iris) and no erosion of conjunctiva (knotless suture). This procedure is a valid surgical option in aphakia, subluxation/luxation of lens, IOL or capsular bag and IOL complex, allowing a good anatomical outcome. The best uncorrected and corrected visual acuity is similar to that achieved with regular micro-incision cataract surgery, since the corneal induced astigmatism is the same, due to the use of a single small corneal incision.


Natalia Ferreira
Porto, Portugal
Email : nataliferre@gmail.com
Cell Phone: +351914043706
Work Phone: +351914043706