Implantable Capsular Hook Technique for Sutureless Scleral Fixation of the Capsular Bag in Lens Subluxation

To describe a technique for implanting capsular hooks made from a 7-0 polypropylene sutures, used for sutureless scleral fixation of the capsular bag in cases of lens subluxation.

A 26-G needle was used to guide the 7-0 polypropylene suture into the eye. The suture was then extracted and thermally shaped into a hook. A needle holder clamped the built-in suture needle, allowing it to pass through the superficial layer of the sclera at the puncture site. Both hands coordinated the subsequent procedure: The suture was pulled externally, while the hook was advanced internally to vertically engage with the capsular bag at the site of continuous curvilinear capsulorhexis.

This technique was applied to 11 eyes of 11 patients. The best-corrected visual acuity improved from a preoperative mean of 1.15 ± 0.39 logarithm of the minimum angle of resolution [logMAR] (Snellen 20/206) to 0.18 ± 0.15 logMAR (Snellen 20/29) at the final follow-up. Throughout the follow-up period, the capsular hook exerted stable vertical traction on the capsular bag at the site of the continuous curvilinear capsulorhexis without slippage.

The capsular hooks made from 7-0 polypropylene sutures provide an effective alternative method for stabilizing the capsular bag in cases of moderate to severe lens subluxation.