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Updated: Jun 21, 2026
Iris Fixation via External Pentagram Suturing
Published on: May 5, 2022
L-SUTURE TECHNIQUE FOR TRANSSCLERAL INTRAOCULAR LENS FIXATION
Subinuer Alimu1,2, Nan Luo1, Liyi Zhao1,3
1State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-sen University, Guangzhou, China.
Purpose:
To report the clinical outcomes of a modified suture technique used for transscleral intraocular lens (IOL) fixation.
Methods:
This study enrolled patients with aphakia, dislocated IOL, or crystalline lens luxation. All eyes underwent transscleral IOL fixation using the L-suture technique. The maximum tensile strength of the L-suture fixation was evaluated in vitro and compared with the Z-suture technique. Outcome measures included best-corrected visual acuity, corneal endothelial cell density, IOL tilt, and postoperative complications.
Results:
This case series included 35 eyes of 33 consecutive patients. The mean follow-up time was 21 ± 7 months. The mean best-corrected visual acuity improved from 0.25 ± 0.29 logMAR (Snellen 20/36) at baseline to 0.09 ± 0.13 logMAR (Snellen 20/25) at the final follow-up ( P = 0.001). At the last visit, corneal endothelial cell count decreased by 7.2% ( P < 0.05), and the mean tilt angle of IOL was 2.91 ± 2.21°. Common intraoperative complications included subconjunctival hemorrhage occurred (5/35; 14.3%) and edematous conjunctiva (3/35; 8.6%). Postoperative complications included IOL iris capture (4/35; 11.4%) and transient ocular hypertension (4/35; 11.4%). In ex vivo testing, the maximum tensile strength of the L-suture fixation was higher than that of the Z-suture fixation ( P < 0.01).
Conclusion:
The L-suture technique provides a satisfying postoperative IOL position with robust fixation while minimizing invasiveness.
