Complications in posterior segment after transscleral suturing of the posterior chamber in intraocular lens implantation

PURPOSE: To investigate complications in the posterior segment after transscleral suturing of the posterior chamber in intraocular lens (PC-IOL) implantation. METHODS: Preoperative clinical characteristics and clinical course were analyzed in 13 eyes of 13 patients who underwent vitreous surgery for either suprachoroidal hemorrhage or rhegmatogenous retinal detachment after transscleral suturing in PC-IOL implantation. RESULTS: Preoperative low intraocular pressure (IOP) was found in 3 of 6 eyes with suprachoroidal hemorrhage (50%) and longer axial length in 3 eyes (50%). Retinal reattachment was achieved in 4 eyes (67%) and final vision was more than 0.1 in 3 eyes (50%). In 7 eyes of retinal detachment, retinal tear was undetected preoperatively in 3 eyes (43%), and retinal breaks were located in the superior quadrant in 5 eyes (71%), similar to the characteristics of aphakic retinal detachment. The retina was reattached in all eyes and vision improved to more than 2 Snellen lines in 6 eyes(86%). CONCLUSION: Low IOP caused by leakage from the scleral wound was a potential risk for developing suprachoroidal hemorrhage after transscleral suturing in PC-IOL implantation. A complete closure of the wounds may prevent suprachoroidal hemorrhage. Collapse and incarceration of the peripheral vitreous may cause retinal detachment and complete removal of the peripheral vitreous may prevent retinal detachment.