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Minimally invasive four-point scleral refixation for dislocated 4-haptic IOL by horizontal mattress sutures and
Zhao-Liang Zhang1, Jia-Hui Shen1,2, Jun-Yi Chen1
1National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China.
Aim:
To evaluate the clinical outcomes of a new minimally invasive technique using horizontal mattress sutures and Hoffman pockets for four-point refixation of dislocated four-haptic intraocular lenses (IOLs).
Methods:
This retrospective consecutive case series included eyes with dislocated Akreos AO60 IOLs underwent scleral refixation using a horizontal mattress double-needle suture technique with intralamellar knot burial via Hoffman pockets. Clinical outcomes assessed included pre- and postoperative best-corrected visual acuity (BCVA), intraocular pressure (IOP), spherical equivalent (SE), suture duration, IOL centration, and perioperative complications.
Results:
A total of 10 eyes from 10 patients (6 males) were included. The mean age at the time of IOL refixation was 53.10±13.07y (range: 28-68y). The mean interval between initial IOL implantation and dislocation was 8.44±3.54y. The mean postoperative follow-up duration was 11.45±10.30mo. Surgical time averaged 15.3±1.77min, with no intraoperative complications. The mean axial length was 27.16±4.35 mm, with high myopia (HM) as the leading comorbidity (4/10 eyes). Postoperative BCVA significantly improved compared to preoperative values (P=0.025). Postoperative SE was significantly improved compared with preoperative (P=0.01). All IOLs remained centered throughout follow-up.
Conclusion:
This minimally invasive four-point scleral fixation technique offers a safe and effective refixation strategy for dislocated four-haptic IOLs. The horizontal mattress suture configuration combined with Hoffman pockets facilitates durable centration, avoids conjunctival dissection, and could be adopted into routine surgical practice.
