Adjustable 6-0 polypropylene flanged technique for scleral fixation, part 2: repositioning of subluxated IOLs
1From the Department of Ophthalmology, Meir Medical Center (Assia), Kfar Saba, Israel; Sackler School of Medicine, Tel Aviv University (Assia), Tel Aviv, Israel; Ein-Tal Eye Center (Assia), Tel Aviv, Israel; and National Healthcare Group Eye Institute, Tan Tock Seng Hospital (Wong), Singapore.
Purpose:
To describe the technique of modified adjustable flange scleral fixation using 6-0 polypropylene sutures for repositioning of subluxated intraocular lenses (IOLs).
Setting:
Center for Applied Eye Research, Meir Medical Center, and the Ein-Tal Eye Center, Israel.
Design:
Case series.
Methods:
Subluxated capsular-fixated posterior chamber IOLs are secured to the sclera using 6-0 polypropylene sutures looped around the IOL haptics. This method can be performed for any type of IOL: hydrophobic, hydrophilic, silicone, or poly(methyl methacrylate); 1-piece or 3-piece; and with either closed-loop or open-loop haptics. It can also be used in conjunction with capsular stabilizing devices.
Results:
In the 18 cases performed, successful repositioning with stable and central fixation of the IOLs was achieved. One eye required a repeated surgery due to suture slippage. The eyes recovered relatively quickly with noted quiescence as early as 1 week postoperatively. Patients did not complain of ocular irritation from the subconjunctival flange up to the 6-month follow-up period. In 1 case, a flange was exposed postoperatively but the patient refused additional intervention and developed intraocular infection 7 months postoperatively.
Conclusions:
The adjustable 6-0 polypropylene flanged technique for IOL repositioning and scleral fixation was a relatively quick and simple method for management of subluxated IOLs. Complete coverage of the flange by conjunctiva and Tenon layer must be confirmed at the end of surgery.
