Four-Point Gore-Tex Scleral Fixation Using A Novel "ALL-IN-ONE" Hydrophilic Acrylic Intraocular Lens With Integrated...

Area of Science:

• Ophthalmology
• Surgical Techniques
• Ocular Implants

Background:

• Persistent monocular diplopia can occur after cataract surgery due to intraocular lens (IOL) decentration from significant zonular dialysis.
• Iridodonesis may accompany severe zonular dialysis, compromising IOL stability within the capsular bag.

Purpose of the Study:

• To describe a novel surgical technique utilizing four-point Gore-Tex scleral fixation for a foldable hydrophilic acrylic intraocular lens (IOL) with integrated eyelets (UnA IOL).
• To report the postoperative outcomes of this technique in a patient with substantial zonular deficiency.

Main Methods:

• A 62-year-old female patient with monocular diplopia and IOL decentration due to >120° zonular dialysis underwent IOL explantation and pars plana vitrectomy.
• The UnA IOL was implanted using a four-point Gore-Tex CV-8 scleral fixation technique.

Main Results:

• Postoperative resolution of monocular diplopia occurred on the first day.
• Best-corrected visual acuity improved from 20/30 to 20/20 at one month.
• Ultrasound biomicroscopy confirmed excellent IOL centration and stability over a 6-month follow-up, with no complications like suture erosion or inflammation.

Conclusions:

• Four-point Gore-Tex scleral fixation with the UnA IOL provides excellent centration, stability, and safety in eyes with significant zonular loss.
• The UnA IOL's design facilitates foldability and accessibility, making it a practical option for secondary IOL implantation when capsular support is inadequate.