Scleral-fixated intraocular lens is indicated under which condition?

• A. When there is insufficient capsular support due to zonular weakness or rupture
• B. When there is intact capsular support
• C. When there is corneal scarring
• D. When anterior chamber depth is shallow

Answer: (A)

Scleral-fixated intraocular lenses are used when the eye cannot support a lens in the natural bag because the capsule or the zonules are damaged or missing. When capsular support is insufficient due to zonular weakness or rupture, the lens can’t be placed securely in the lens capsule, so fixing it to the sclera provides stable, pseudo–posterior-chamber support. That’s why this is the best indication. If there is intact capsular support, the standard in-the-bag placement is preferred. Corneal scarring doesn’t dictate scleral fixation, and while a shallow anterior chamber depth influences lens choice, it isn’t the primary indication for scleral fixation.