4-Flanged Iol Scleral Fixation Stability Following Corneal Perforation

We describe a case of a stable intraocular lens (IOL) fixated earlier via the 4-flanges scleral fixation technique in a patient who presented with  amajor blunt trauma and corneal perforation

Retrospective evaluation of patient's medical background was collected from Shamir Medical Center's data. 

81-year-old man, with previous left eye (LE) keratoplasty and an uneventful cataract surgery, admitted to the emergency department (ED) after a head blunt trauma involving the left eye. On examination, LE corneal graft detachment was noticed as well as an IOL dislocation. He underwent multiple surgeries including preliminary corneal perforation closure, posterior vitrectomy with IOL implant extraction, IOL 4-flange scleral fixation and another penetrating keratoplasty (PKP) corneal graft re-implant. A month later, he was re-admitted to the ER with another blunt head and eye trauma. The patient suffered a second corneal perforation, yet the IOL was fixed and steady with no need for further intervention.

The 4-flanged IOL scleral fixation technique creates a steady and liable construction that keeps the IOL centered and stable, following significant blunt trauma.