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A Toric Plate-Haptic Intraocular Lens Suitable for Flanged Scleral Fixation
Avner Belkin1,2,3, Gal Harel2,3, Adi Zaslavsky2,3
1Ein-Tal Eye Center, Tel-Aviv, Israel.
Purpose:
To report clinical experience with a modified toric plate-haptic lens (VisTor; Hanita Lenses) also suitable for four-point scleral fixation in eyes without capsular support.
Methods:
The commercial VisTor lens design was modified by adding two positioning holes in the lens haptic to facilitate four-point fixation. The lens axis was marked preoperatively, and the insertion points of the sutures were marked 2 mm from the limbus and 2 mm on each side of the toric marks. Polypropylene 6-0 or 7-0 sutures were inserted through the sclera and threaded through the designated holes in the intraocular lens (IOL) haptics. Four-point fixation was achieved by creation of four external flanges.
Results:
Fifteen lenses were implanted in 15 eyes lacking capsular support. One patient was lost to follow-up and excluded from final analysis. The average age was 48 ± 22 years (range: 26 to 79 years). Surgery was secondary implantation in aphakia in 9 eyes, combined with crystalline lens removal in 3 eyes, and combined with IOL exchange in 3 eyes. The final position of the IOL was within 4 degrees of the planned axis in all eyes. No tilt was noted postoperatively and satisfactory visual improvement was achieved in all cases but one, in which vision loss was related to advanced glaucoma.
Conclusions:
Four-point scleral fixation of a plate-haptic IOL provides precise and stable IOL positioning with no tilt and accurate toric correction in eyes lacking capsular support.
