In some cases of cataract surgery, the surgeon does not feel it is safe to insert an intraocular lens into the eye. This generally happens in cases of complicated cataract surgery. When this happens, the patient is often scheduled for a second surgery for lens insertion.
Depending on the anatomy of the eye and whether the “bag” that was holding the original lens is intact, the surgeon may decide to place the new intraocular lens directly into the “bag” that was holding the previous intraocular lens, or may position the new lens in other parts of the eye (e.g. in front of the “bag,” a region called the sulcus; or alternatively in front of the iris). When no “bag” is present, the surgeon may fixate a lens to the wall of the eye (called the sclera) or to the iris. Several techniques exist to fixate the lens to the eye, some involving and others without sutures.
The surgeon will usually pick a technique based on his/her experience. Sometimes, the jelly from the back of the eye (the vitreous) comes forward during the surgery, and the surgeon has to remove some of it (a procedure called a vitrectomy).
Wills Eye Cornea Specialists