Three-flanged capsular hook for zonular dialysis repair.

Area of Science:

• Ophthalmology
• Surgical Techniques
• Medical Devices

Background:

• Cataract surgery requires intact zonular support for proper intraocular lens (IOL) placement.
• Preoperative zonular deficiency and intraoperative zonular dialysis pose significant challenges during cataract surgery.
• Existing techniques for managing zonular instability may have limitations.

Purpose of the Study:

• To describe a novel surgical technique using a three-flanged Prolene suture for managing zonular dialysis.
• To evaluate the efficacy and safety of this technique in a patient with preoperative zonular deficiency and brown cataract.
• To demonstrate stable IOL positioning and good visual outcomes.

Main Methods:

• A three-flanged Prolene suture was fashioned in an iris hook-like configuration.
• The suture was passed through the zonular defect using a 26-gauge needle.
• A capsular tension ring (CTR) was placed, and the suture engaged the dialysis site for stabilization.
• The suture was secured, and an IOL was implanted in the capsular bag.

Main Results:

• The three-flanged Prolene suture technique successfully managed zonular dialysis without intraoperative complications.
• Postoperative visual acuity was 6/9 with normal intraocular pressure.
• The IOL remained stable, indicating effective capsule stabilization and positioning.

Conclusions:

• The three-flanged Prolene suture technique is a safe and effective method for managing zonular instability during cataract surgery.
• This technique, combined with a CTR, ensures capsule stabilization and optimal IOL positioning.
• It offers reliable outcomes for complex cases, including subluxated cataracts and intraoperative zonular dehiscence.