The Suture-In-Needle, Closed-Loop Technique for Repositioning a Dislocated Akreos Adapt Intraocular Lens

Purpose: To evaluate a modified minimally invasive technique for trans-scleral repositioning of dislocated Akreos Adapt intraocular lenses (IOLs) without scleral flaps. Methods: This retrospective case series included 17 eyes with subluxated or dislocated IOLs that underwent repositioning using a suture-in-needle, closed-loop technique. The procedure involved passing an 8-0 polypropylene suture through the IOL's four fenestrated haptics using a bent 30-gauge needle. The exterior suture knot was buried into the sclera without creating scleral flaps or dissecting the conjunctiva. Data on pre- and postoperative intraocular pressure, best-corrected visual acuity, IOL position, corneal endothelial cell counts, and intra-/postoperative complications were collected and analyzed. The follow-up period lasted at least 6 months. Results: All 17 cases demonstrated stable and well-centered IOLs with improved visual acuity. No significant complications, including IOL tilt, decentration, vitreous hemorrhage, hypotony, iris capture, or suture erosion, were observed during the follow-up. Conclusion: The suture-in-needle, closed-loop technique for trans-scleral refixation of dislocated Akreos Adapt IOLs is minimally invasive, achieves excellent anatomical and functional outcomes, and reduces the risk of complications.