This aphakic patient presented following removal of an anteriorly subluxed cataract. She had suffered an attack of acute angle closure many years prior, and, despite being treated with laser PIs, the pupil remained fixed and dilated. Given this history and anatomy I felt a scleral sutured PC IOL would be most appropriate. Hoffman scleral pockets were employed with an ab externo passage of 8-0 Gore-tex suture secured to the fixation eyelets of the IOL haptics with a cowhitch. After the IOL was placed and secured the fixed and dilated pupil was modified with two interrupted 10-0 Prolene sutures placed with Siepser sliding knots. The patient has done well with 20/20 corrected vision. Video by Jason Jones, MD.
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