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Robert L. Bergren, MD
Pittsburgh, Pa

Arch Ophthalmol. 1995;113(8):969-970.

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In reply

I thank Drs Shin and Hughes for their comments, especially for correctly pointing out my omission of the first reported series of transscleral suture-fixated posterior chamber lenses through the limbal approach. However, Drs Shin and Hughes incorrectly interpreted my comments. My article never claims, and I do not believe, that a transscleral suture-fixated posterior chamber lens requires four-point fixation for stable placement. Stable placement without torsion can be achieved with two-point fixation if the lens is placed far enough anteriorly so that the iris prevents any lens torsion. Broad contact in the ciliary sulcus or over the ciliary body prevents improper centering but not lens torsion. My method of suture fixation is simply a means of stabilizing the attachment of the suture to the lens haptic against torsion in case the placement of the suture is slightly posterior. Placement of sutures through the ciliary sulcus depends on the . . . [Full Text PDF of this Article]

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