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Iris Fixation via External Pentagram Suturing
Published on: May 5, 2022
Ab externo scleral suture loop fixation for posterior chamber intraocular lens decentration: clinical results
Clara C Chan1, Alan S Crandall, Iqbal Ike K Ahmed
1Department of Ophthalmology and Vision Sciences, University of Toronto, Ontario, Canada.
Purpose:
To evaluate the efficacy and safety of an ab externo suture retrieval and scleral fixation technique in the treatment of subluxated posterior chamber intraocular lenses (PC IOLs).
Setting:
Academic tertiary care centers.
Methods:
Surgical databases from 2 surgeons were reviewed for consecutive cases from March 2000 to April 2004 in which the ab externo scleral suture fixation technique was used and a minimum follow-up of 3 months was completed. Patient charts were reviewed for 15 eyes that had decentered in-the-bag PC IOLs, 12 eyes with subluxated sulcus or bag-sulcus positioned PC IOLs, and 3 eyes with PC IOLs dislocated into the vitreous.
Results:
The mean time from cataract extraction to PC IOL stabilization was 3.4 years (range 2 days to 10.9 years). Surgical repositioning was successfully performed in all patients. After a mean follow-up of 14.7 months, the mean best corrected visual acuity (BCVA) improved from 20/140 to 20/40 (P = .0001). All patients had stable or improved BCVA. All patients with a successfully completed procedure achieved an adequately centered PC IOL postoperatively. One patient (3.3%) developed a significant intraoperative vitreous hemorrhage requiring the procedure to be aborted, but reoperation 3 months later was successful. Postoperative complications included persistent elevated intraocular pressure in 2 eyes (6.7%) and chronic cystoid macular edema in 1 eye (3.3%) that resolved with medication.
Conclusion:
The ab externo suture loop retrieval and scleral fixation technique was effective in repositioning decentered, subluxated, or dislocated PC IOLs with excellent visual outcomes.
