The novel triangular suture technique for intraocular Lens fixation in patients with pseudoexfoliation syndrome...

IntroductionThe current case series presents the triangular suture technique (TST) for managing intraocular lens (IOL) subluxation in pseudoexfoliation (PXF) syndrome patients, a condition increasing the risk of IOL dislocation post-cataract surgery. The series includes three PXF patients treated with TST for dislocated IOLs.Case descriptionThe first case is an 88-years old woman with recurrent IOL dislocation post-Hoffman pocket fixation. TST resulted in successful IOL centration and significant visual acuity improvement, with uncorrected visual acuity (UCVA) improving from 6/60 to 6/15 and best-corrected visual acuity (BCVA) reaching 6/7.5 at three months. The surgery took 21 min with no major complications. The second case involves a 90-year-old man with posterior IOL dislocation and poor vision (UCVA of counting fingers at 1 meter). TST achieved good IOL repositioning and improved BCVA to 6/20 at three weeks. The last case presents an 82 years old woman with PXF and glaucoma, experiencing IOL subluxation post-traumatic cataract surgery. TST successfully centralized the IOL, improving non-corrected visual acuity from 6/30 to 6/10 at six weeks, and BCVA to 6/6.67 at four years. Intraocular pressure remained well-controlled.ConclusionsThis series highlights TST as an effective and safe solution for IOL subluxations in PXF patients, with successful outcomes in all cases. TST offers ease of learning and faster execution, suitable for anterior segment surgeons without extensive vitreoretinal experience. Further studies are needed to confirm the long-term efficacy and safety of TST, ideally involving larger cohorts and longer follow-ups.