A Novel Approach to Scleral Fixation of Posterior Chamber Intraocular Lenses and Capsular Tension Rings and Segments in Deep-Set Eyes

Abstract

Purpose: To demonstrate a novel approach to scleral fixation of posterior chamber intraocular lenses and capsular tension rings and segments in deep-set eyes using the Finesse FlexLoop (Alcon Laboratories).Methods: The technique described herein, based on previous approaches to scleral fixation of posterior chamber intraocular lenses, uniquely employs the FlexLoop to "lasso" Gore-Tex sutures that have already been threaded through the eyelets of a CZ70BD (Alcon Laboratories) IOL and externalize them.Results: All patients who underwent surgery with this technique experienced visual improvement. The only complication was of mild hyphema in the patient who had a capsular tension segment placed, which resolved with medical therapy. Conclusion:The advantages of this procedure include a smaller diameter instrument (FlexLoop) as compared to the 25-gauge forceps typically employed, an easier to perform surgical maneuver that alleviates the need for both precise placement and constant tension to be exerted by the surgeon to grasp the sutures, as well as an instrument that can function when bent up to 45°to help accommodate deep-set eyes requiring this procedure.

Urrets-Zavalia syndrome following placement of scleral-sutured intraocular lens

“…The enVista MX60E intraocular lens was then implanted using a previously described technique. 8 In brief, small conjunctival peritomies were made inferotemporally and superonasally. Two sclerotomies were made within each peritomy, 4 mm apart from one another and 3 mm posterior to the limbus, as measured by calipers.…”