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Updated: Jul 17, 2025

Iris Fixation via External Pentagram Suturing
Published on: May 5, 2022
Clinical Experience of Two Sutureless Intrascleral Fixation Techniques for Secondary Intraocular Lens Implantation
Kai Januschowski1,2, Annekatrin Rickmann1, Karl T Boden1
1Eye Clinic Sulzbach, Knappschaft Hospital Saar, Sulzbach, Germany.
Introduction:
The aim of this study was to evaluate the outcome of the modified Carlevale intraocular lens (IOL) fixation technique, using two different vitrectomy ports (23- vs. 27-gauge) as anchor fixation.
Methods:
Retrospective, consecutive study of 282 eyes (282 patients) who underwent a secondary IOL implantation using the Carlevale IOL (Soleko IOL Division, Italy) with two anchor haptics for intrascleral implantation with either 23- or 27-gauge (G) port.
Results:
Transient post-operative ocular hypotonia (intraocular pressure ≤5 mm Hg) was observed less in the 27-G group (13 vs. 4 patients, p = 0.057) three requiring additional tunnel sutures (2 cases for 23-G; 1 case 27-G). Post-operative vitreous haemorrhage was recorded more often in the 23-G group (8 vs. 1 patient, p = 0.034), but all cases in both groups resolved without intervention. Visual acuity did improve post-operatively in the two groups. No post-operative complications such as retinal detachment, endophthalmitis, and IOL-dislocation tilt were observed in the follow-up.
Conclusion:
The 27-G modified technique for sutureless intrascleral implantation is simple and effective and causes less post-operative hypotony.

