Clinical Study Ultrasound Biomicroscopy Comparison of Ab Interno and Ab Externo Intraocular Lens Scleral Fixation Lie Horiguchi, 1 Patricia Novita Garcia, 1,2 Gustavo Ricci Malavazzi, 1,2 Norma Allemann, 2 and Rachel L. R. Gomes 2,3 1 Department of Ophthalmology, Irmandade da Santa Casa de Miseric´ ordia de S˜ ao Paulo, S˜ ao Paulo, SP, Brazil 2 Department of Ophthalmology, Federal University of S˜ ao Paulo, S˜ ao Paulo, SP, Brazil 3 Hospital de Olhos Paulista, Rua Ab´ılio Soares 218, 04005-000 S˜ ao Paulo, SP, Brazil Correspondence should be addressed to Rachel L. R. Gomes; rachelgomes@novais.md Received 22 March 2016; Revised 1 May 2016; Accepted 4 May 2016 Academic Editor: Sang Beom Han Copyright © 2016 Lie Horiguchi et al. is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Purpose. To compare ab interno and ab externo scleral fixation of posterior chamber intraocular lenses (PCIOL) using ultrasound biomicroscopy (UBM). Methods. Randomized patients underwent ab externo or ab interno scleral fixation of a PCIOL. Ultrasound biomicroscopy was performed 3 to 6 months postoperatively, to determine PCIOL centration, IOL distance to the iris at 12, 3, 6, and 9 hours, and haptics placement in relation to the ciliary sulcus. Results. Fiſteen patients were enrolled in the study. e ab externo technique was used in 7 eyes (46.6%) and the ab interno in 8 eyes (53.3%). In the ab externo technique, 14 haptics were located: 4 (28.57%) in the ciliary sulcus; 2 (14.28%) anterior to the sulcus; and 8 (57.14%) posterior to the sulcus, 6 in the ciliary body and 2 posterior to the ciliary body. In the ab interno group, 4 haptics (25.0%) were in the ciliary sulcus, 2 (12.50%) anterior to the sulcus, and 10 (75.0%) posterior to the sulcus, 4 in the ciliary body and 6 posterior to the ciliary body. Conclusions. Ab externo and ab interno scleral fixation techniques presented similar results in haptic placement. Ab externo technique presented higher vertical tilt when compared to the ab interno. 1. Introduction Capsular bag is the standard of care for posterior chamber intraocular lens (IOL) placement. However, if the capsular support is absent, many techniques can be used to fixate the lens. Ab interno and ab externo are trans scleral suture tech- niques described to fixate a posterior chamber intraocular lens (PCIOL) [1–3]. Nevertheless, other techniques to fixate an IOL have been described, such as the no-suture technique that places the IOL haptic inside a scleral tunnel [4–6]. e aim of fixation is to position the haptics in the ciliary sulcus; however, these procedures are performed without direct visualization of the path of the needle. Direct view techniques, guided by endoscopic probe, have greater rate of success in lens centration and correct haptic position [7, 8]. is technique is considered the gold standard; however, it requires particular equipment and specific training. Ultrasound biomicroscopy (UBM) is an effective method to study the anterior segment and haptics placement behind the iris [9]. In this study we compared ab interno and ab externo techniques to evaluate both haptics position in relation to ciliary sulcus and the IOL distance from iris plane determining vertical and horizontal tilt using UBM. 2. Methods is study was approved by the Santa Casa de S˜ ao Paulo Ethics Committee. Patients scheduled for IOL implantation were randomly assigned to participate in one of the groups. Scleral fixation was performed aſter a complete ophthalmic examination. Surgery was scheduled according to patient’s intraocular inflammation status. Patients with any sign of active inflammation or best-corrected visual acuity worse than 20/40 during the recruitment timeframe were excluded from this study. In one group, the IOL was fixated using Hindawi Publishing Corporation Journal of Ophthalmology Volume 2016, Article ID 9375091, 5 pages http://dx.doi.org/10.1155/2016/9375091