"Lens lasso" repositioning of dislocated posterior chamber intraocular lenses

Dislocation of posterior chamber intraocular lenses poses unique surgical problems for the vitreous surgeon. Although many methods have been devised to correct this problem, none are easily accomplished. A new technique that simplifies this task is described.

Six patients with complete posteriorly dislocated posterior chamber intraocular lenses underwent this procedure. Five lenses had prolene haptics and one was all polymethylmethacrylate. All except one traumatic case were spontaneous dislocations. A 9-0 prolene suture was transocularly placed through opposite sides of the ciliary sulcus; slip knots were tied on the internal ends and these knots then used to "lasso" the intraocular lens haptics. This achieved, the lens was easily pulled back up into the ciliary sulcus.

All patients tolerated the procedure well without any complications. Lens centering was excellent and the externalized sutures showed no erosion through the conjunctiva. Visual acuity was 20/40 or better in all but the one patient with traumatic dislocation, who had a final visual acuity of 20/100. Average length of follow-up period was 17 months.

This surgical technique offers distinct advantages to the surgeon by eliminating cumbersome manipulation of the dislocated intraocular lens, more accuracy in lens replacement, and secure suture attachment to the lens haptics.