Management of late in-the-bag IOL dislocation with exchange and scleral fixation of IOL with the transfixion technique

Purpose. To describe a method to overcome the nonavailability of a long needle 9-0 polypropylene suture for sutured scleral fixation of the posterior chamber intraocular lens (PC-IOL) using a single fisherman’s knot (SFK). Methods. First, a 10-0 polypropylene suture was passed from the sclera to the ciliary sulcus using a long needle. A 9-0 suture was tied to the unpassed portion of the 10-0 suture with an SFK. We pulled the 10-0 suture to pass the SFK through the sclera, and then we cut the knot and removed the 10-0 suture. IOL fixation with 9-0 sutures used the conventional techniques used for sutured scleral-fixated IOL. Preoperative and postoperative visual acuity, corneal astigmatism, and endothelial cell count and intraoperative/postoperative complications were evaluated. Results. An SFK joining the two sutures was passed through the sclera without breakage or slippage. A total of 35 eyes from 35 patients who underwent sutured scleral fixation of the IOL. An intraoperative complication (minor intraocular hemorrhage) was recorded in four cases. Knot exposure, IOL dislocation, subluxation, and retinal detachment were not observed. Conclusions. The SFK offers the opportunity to use 9-0 sutures for the long-term safety and may not require the surgeon to learn any new technique.

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Modified Scleral Fixation of Dislocated Posterior Chamber Intraocular Lenses

Journal of the Korean Ophthalmological Society ◽

10.3341/jkos.2009.50.7.1071 ◽

2009 ◽

Vol 50 (7) ◽

pp. 1071 ◽

Cited By ~ 6

Author(s):

Deok Goo Lee ◽

Ki Yup Nam ◽

Jung Yeul Kim

Keyword(s):

Intraocular Lenses ◽

Posterior Chamber ◽

Scleral Fixation

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Sutured scleral fixation of posterior chamber intraocular lens in children under the age of 9 with congenital ectopia lentis

Ophthalmic Research ◽

10.1159/000516324 ◽

2021 ◽

Author(s):

Xuyun Meng ◽

Xi Cao ◽

Yiyue Jia ◽

Jianhui Pan ◽

Yi Du ◽

...

Keyword(s):

Intraocular Lens ◽

Posterior Chamber ◽

Ectopia Lentis ◽

Scleral Fixation ◽

Posterior Chamber Intraocular Lens

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The simply modified intrascleral fixation using round flange (SMURF) technique for intrascleral intraocular lens fixation

Scientific Reports ◽

10.1038/s41598-021-81924-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Soa Kim ◽

Jee Taek Kim

Keyword(s):

Intraocular Lens ◽

Invasive Procedure ◽

Crystalline Lens ◽

Early Postoperative Period ◽

Cystoid Macular Oedema ◽

Modified Technique ◽

Intraocular Pressure Elevation ◽

Wound Leakage ◽

Iol Dislocation

AbstractWe describe a simply modified intrascleral fixation using round flange (SMURF) technique and report the clinical outcomes of the surgery. Forty-one eyes of 41 consecutive patients, with intraocular lens (IOL) dislocation, crystalline lens subluxation, and zonular weakness, who underwent surgery using the SMURF technique were included. The modified technique included the use of a conventional 27-gauge needle, a non-bent needle, oblique sclerotomy, direct threading of the leading haptic, and simple placement of the following haptic. IOLs were successfully placed and showed good centring. There were no cases of wound leakage or hypotony during the early postoperative period. Postoperative complications included vitreous haemorrhage in one eye (2.4%), intraocular pressure elevation in one eye (2.4%), and iris capture in six eyes (14.6%). There were no cases of postoperative retinal detachment, cystoid macular oedema, endophthalmitis, or IOL dislocation during the follow-up period. We proposed a few modifications in the intrascleral flanged technique for IOL fixation. The modified technique is a simple, easy, and minimally invasive procedure for successful IOL intrascleral fixation.

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Adjustable 6-0 polypropylene flanged technique for scleral fixation, part 1: primary fixation IOLs in aphakia, capsular stabilizing devices, and aniridia implants

Journal of Cataract & Refractive Surgery ◽

10.1097/j.jcrs.0000000000000260 ◽

2020 ◽

Vol 46 (10) ◽

pp. 1387-1391

Author(s):

Ehud I. Assia ◽

John X.H. Wong

Keyword(s):

Scleral Fixation

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Intraocular Lens Dislocation after Cataract Surgery in Tambolaka, Southwest Sumba, Indonesia: A Case Report

Case Reports in Ophthalmology ◽

10.1159/000487228 ◽

2018 ◽

Vol 9 (1) ◽

pp. 179-184

Author(s):

Ratna Sitompul

Keyword(s):

Case Report ◽

Intraocular Lens ◽

Rural Areas ◽

Rare Complication ◽

Cataract Extraction ◽

Factors Affecting ◽

Intraocular Lens Dislocation ◽

Post Surgery ◽

The Right ◽

Iol Dislocation

Intraocular lens (IOL) dislocation is a rare complication of cataract extraction requiring prompt surgery. This case report aims to raise awareness of such cases and the importance of post-surgery follow-up. A 58-year-old female patient was found with anterior IOL dislocation a week after phacoemulsification surgery in her right eye. Visual acuity of the right eye was 1/60 with ciliary injection and IOL dislocation to the anterior chamber of the right eye. The patient underwent surgery of the right eye and the IOL haptic was found to be broken. In this case report, the factors affecting IOL dislocation are axis length, broken IOL haptic, and patient activity that increased intraocular pressure. Cataract extraction surgery, although common, needs to be conducted carefully, and it is important for ophthalmologists and general practitioners to detect this condition, especially in rural areas where facilities are limited, as IOL dislocation could occur and requires immediate treatment to achieve a better result.

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