L-SUTURE TECHNIQUE FOR TRANSSCLERAL INTRAOCULAR LENS FIXATION.

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.