LAUSR

According to the 2015–2019 survey by the National Programme for Control of Blindness and Visual Impairment, uncorrected aphakia accounts for 1.7% of blindness and vision impairment in adults aged >50 years in India.[1] Anisometropia, aniseikonia, prismatic distortion of images (jack-in-the-box phenomenon) and the weight of high hyperopic spectacles demands rehabilitation in surgical aphakia with an intraocular lens (IOL) implantation. IOLs provide a better field of vision and less image disparity, and are more acceptable cosmetically. The standard of care of in-the-bag implantation of an IOL, may not be feasible in circumstances where there is a lack of posterior capsular support. Such instances are not uncommon in a regular cataract surgeon’s practice. Further recourse depends on the presence or absence of sulcus support. While, in the presence of an adequate sulcus support, a foldable 3-piece or a rigid polymethyl methacrylate (PMMA) IOL is preferred, in its absence, the choice of IOL fixation depends on the surgeon’s expertise.