<p>Scleral Fixation of Single-Piece Foldable IOL Using Double-Flanged Technique</p>

Abstract

Purpose: To describe the efficiency and visual results of a new method of transconjunctival intrascleral fixation of single-piece foldable IOL using double-flanged 6/0 prolene suture. Materials and Methods: Seventeen aphakic eyes of 17 patients without adequate capsular support were involved in this study. Lens was prepared by passing the 6/0 prolene suture in a track in the haptic of single-piece foldable IOL created by 31 g needle. The 6/0 prolene suture was retrieved through a 30 g needle transconjunctivally to outside the globe; then, IOL was implanted and a terminal bulb was created at the outer end of the prolene suture. Results: All cases were aphakic after complicated phacoemulsification. In 10 cases hydrophilic IOLs were used and in 7 cases hydrophobic IOLs were used. There is clear statistically significant difference between pre-UCVA and post-UCVA. Complications included suture slippage in 2 cases and prolene bulb exposure in one case. There was no significant difference in endothelial cell count and IOP before and after 3 months. Conclusion: Transconjunctival intrascleral fixation of foldable single-piece IOLs is a safe efficient method for correcting aphakia.

Intrascleral anchoring knot on the double suture without peritomy for fixation of intraocular lens

“…Concerns regarding 10-0 polypropylene suture degradation and breakage, especially in young patients, force the use of larger diameter polypropylene, polytetrafluoroethylene (Gore-Tex), or sutureless techniques by capturing IOL haptics into the sclera. 1–8,10–12,18–20…”

“…A flange-making approach of scleral fixation without peritomy is also widely used with bulb creation on both ends of 6-0 polypropylene thread for soft IOL, CTD, and iris prosthesis or 5-0 polypropylene thread for CTD anchoring. 1,4,6,7 Inherited postoperative complications of these techniques are similar to those of the Yamane flanged fixation and related to a short scleral tunnel fixing the bulb. They are the risks for suture slippage, bulb exposure, and hypotony.…”

“…1–12 Options for sparing conjunctival integrity include fixing the suture knots in the reversed Hoffman scleral pockets, anchoring IOL haptics or flanges of the haptics within sclera, and capturing flanges or knots of the threads within sclera, or knots of the threads within corneal paracenteses. 1–4,6,7,12–16…”

“…The long-term durability of scleral fixation can be achieved either by using a suture material thicker than 10-0, double suture, or by capturing IOL haptics within sclera. [1][2][3][4][5][6][7][8][9][10][11][12] Options for sparing conjunctival integrity include fixing the suture knots in the reversed Hoffman scleral pockets, anchoring IOL haptics or flanges of the haptics within sclera, and capturing flanges or knots of the threads within sclera, or knots of the threads within corneal paracenteses. [1][2][3][4]6,7,[12][13][14][15][16] Widely adopted Yamane flanged haptics scleral fixation, which has been evolved from the Gabor technique, meets both requirements.…”

Early Clinical Outcomes of Intrascleral Fixation Using an Intraocular Lens with Hook-Shaped Haptics

“…The intrascleral IOL fixation technique has been improved since it was first reported by Gabor SG and Agarwal et al [2][3][4][5][6][7][8][9][10][11][12] Currently, there are two major methods of scleral fixation: (i) the haptics of an existing IOL are grasped with forceps, externalized from the eye, and buried in the scleral tunnel, as represented by the Y-fixation technique (tunnel technique), 7 or (ii) the haptics of an IOL are cauterized to create a flange and buried in the sclera, developed by Yamane et al (the flange technique). 5,6 Although both techniques are appropriately sophisticated, the conventional three-piece IOL has been commonly used in both techniques.…”