Surgery Scleral-fixated intraocular lens surgery is a specialized procedure performed when there is insufficient support within the eye to hold a standard intraocular lens, often due to trauma, prior complicated cataract surgery, dislocated lens implants, or conditions like zonular weakness. In these cases, a custom approach is required to securely place the new lens. Rather than resting in the capsular bag, the IOL is sutured or anchored to the sclera-the white outer wall of the eye-for stable and long-term positioning.

This procedure is typically performed in the operating room under local or general anesthesia, depending on patient and surgical needs. Very small incisions are made to allow insertion of microsurgical instruments and the IOL itself. Using fine sutures the lens haptics (support arms) are fixated to the sclera, ensuring precise centering of the lens behind the iris. In many cases, this surgery is combined with a vitrectomy to clear any vitreous gel that may interfere with lens positioning or has prolapsed due to prior surgeries or trauma.

Scleral-fixated IOL surgery provides an excellent option for visual rehabilitation in patients who are not candidates for standard lens implantation. Recovery is typically outpatient, and while vision may take time to stabilize, patients often experience significant improvement in visual function once healing is complete.