BMC ophthalmology · 2025
Snare-assisted flapless closed-loop scleral refixation of dislocated Akreos Adapt intraocular lenses.
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Liu Qing, Zhu Xinlei, Lun Lingxiao, Qin Cong, Wan Lei
Аннотация
PURPOSE: To describe a flapless, single-pass, snare-assisted technique for four-point scleral refixation of dislocated Akreos Adapt intraocular lenses (IOLs) using an 8 - 0 polypropylene suture in a closed-loop configuration.
METHODS: An 8 - 0 polypropylene suture was passed through the four fenestrated haptics of the IOL using a non-sliding snare constructed from a 30-gauge thin-walled needle mounted on a 1 mL syringe. The extraocular portions of the suture were routed within the intrascleral plane between two fixation points on the same side (nasal or temporal), which are 2 mm away from the limbus, with a distance of 7 mm between the two fixation points, without conjunctival dissection or scleral flap creation. The external suture knot was buried within the scleral stroma.
RESULTS: This retrospective case series included five eyes with Akreos Adapt IOLs that were completely dislocated into the vitreous cavity. All lenses were successfully fixated without intraoperative complications. At a mean follow-up of 8.4 months, all IOLs remained well-centered and stable. Best-corrected visual acuity improved in all cases. The preoperative and postoperative spherical equivalent values ranged from - 5.00 D to 11.00 D preoperatively, and from - 2.50 D to -0.50 D postoperatively. No hypotony, suture erosion, knot exposure, or IOL redislocation were observed.
CONCLUSION: This technique offers a minimally invasive and reproducible method for four-point scleral fixation of dislocated Akreos Adapt IOLs, eliminating the need for conjunctival or scleral dissection and requiring no specialized instrumentation.
METHODS: An 8 - 0 polypropylene suture was passed through the four fenestrated haptics of the IOL using a non-sliding snare constructed from a 30-gauge thin-walled needle mounted on a 1 mL syringe. The extraocular portions of the suture were routed within the intrascleral plane between two fixation points on the same side (nasal or temporal), which are 2 mm away from the limbus, with a distance of 7 mm between the two fixation points, without conjunctival dissection or scleral flap creation. The external suture knot was buried within the scleral stroma.
RESULTS: This retrospective case series included five eyes with Akreos Adapt IOLs that were completely dislocated into the vitreous cavity. All lenses were successfully fixated without intraoperative complications. At a mean follow-up of 8.4 months, all IOLs remained well-centered and stable. Best-corrected visual acuity improved in all cases. The preoperative and postoperative spherical equivalent values ranged from - 5.00 D to 11.00 D preoperatively, and from - 2.50 D to -0.50 D postoperatively. No hypotony, suture erosion, knot exposure, or IOL redislocation were observed.
CONCLUSION: This technique offers a minimally invasive and reproducible method for four-point scleral fixation of dislocated Akreos Adapt IOLs, eliminating the need for conjunctival or scleral dissection and requiring no specialized instrumentation.