Retina (Philadelphia, Pa.) · 2024
Reverse 4-Flanged Technique for Intrascleral Fixation of a Foldable Hydrophobic Intraocular Lens in the Absence of Capsular Support Through a 2.2-mm Corneal Incision.
СтатьяНазвание и аннотация: Перевод в очереди
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Romero-Valero Daniel, Martínez Toldos Jose Juan
Аннотация
PURPOSE: The purpose of this study was to describe a modified technique for sutureless intrascleral intraocular lens fixation in patients without capsular support: the reverse 4-flanged technique.
METHODS: A 2.2-mm corneal incision was made for aphakic patients. The 6-0 polypropylene sutures were threaded through a 30-gauge needle outside the eye. An MDJ injector was employed to insert the intraocular lens into the eye. A suture-needle snare with 7-0 polypropylene was used to exteriorize the superior end of the sutures through the sclerotomy. The 6-0 polypropylene was heated with a cautery to create the flanges.
RESULTS: Nine eyes of nine patients underwent the reverse 4-flanged technique. The median follow-up time was 182 days (range 174-195). Best-corrected distance visual acuity improved from 20/400 [hand movement-20/33] to 20/120 [20/400-20/21]. No vitreous hemorrhage, retinal detachment, endophthalmitis, intraocular lens luxation, or flange exposure was recorded during the follow-up.
CONCLUSION: The reverse 4-flanged technique maintains the advantages of the original 4-flanged technique in terms of intraocular lens stability while reducing the incision size and surgical maneuvers performed inside the eye. This modification promises to be a reliable, safe, and relatively simple technique to correct aphakia in the absence of capsular support.
METHODS: A 2.2-mm corneal incision was made for aphakic patients. The 6-0 polypropylene sutures were threaded through a 30-gauge needle outside the eye. An MDJ injector was employed to insert the intraocular lens into the eye. A suture-needle snare with 7-0 polypropylene was used to exteriorize the superior end of the sutures through the sclerotomy. The 6-0 polypropylene was heated with a cautery to create the flanges.
RESULTS: Nine eyes of nine patients underwent the reverse 4-flanged technique. The median follow-up time was 182 days (range 174-195). Best-corrected distance visual acuity improved from 20/400 [hand movement-20/33] to 20/120 [20/400-20/21]. No vitreous hemorrhage, retinal detachment, endophthalmitis, intraocular lens luxation, or flange exposure was recorded during the follow-up.
CONCLUSION: The reverse 4-flanged technique maintains the advantages of the original 4-flanged technique in terms of intraocular lens stability while reducing the incision size and surgical maneuvers performed inside the eye. This modification promises to be a reliable, safe, and relatively simple technique to correct aphakia in the absence of capsular support.