Adjustable 6-0 polypropylene flanged technique for scleral fixation, part 2: repositioning of subluxated IOLs.

PURPOSE: To describe the technique of modified adjustable flange scleral fixation using 6-0 polypropylene sutures for repositioning of subluxated intraocular lenses (IOLs).

SETTING

Center for Applied Eye Research, Meir Medical Center, and the Ein-Tal Eye Center, Israel.

DESIGN

Case series.

METHODS

Subluxated capsular-fixated posterior chamber IOLs are secured to the sclera using 6-0 polypropylene sutures looped around the IOL haptics. This method can be performed for any type of IOL: hydrophobic, hydrophilic, silicone, or poly(methyl methacrylate); 1-piece or 3-piece; and with either closed-loop or open-loop haptics. It can also be used in conjunction with capsular stabilizing devices.

RESULTS

In the 18 cases performed, successful repositioning with stable and central fixation of the IOLs was achieved. One eye required a repeated surgery due to suture slippage. The eyes recovered relatively quickly with noted quiescence as early as 1 week postoperatively. Patients did not complain of ocular irritation from the subconjunctival flange up to the 6-month follow-up period. In 1 case, a flange was exposed postoperatively but the patient refused additional intervention and developed intraocular infection 7 months postoperatively.

CONCLUSIONS

The adjustable 6-0 polypropylene flanged technique for IOL repositioning and scleral fixation was a relatively quick and simple method for management of subluxated IOLs. Complete coverage of the flange by conjunctiva and Tenon layer must be confirmed at the end of surgery.