Modified ab-externo scleral fixation method for dislocated scleral fixated intraocular lenses.

Abstract

Sutured scleral fixation of intraocular lenses (SSFIOL) is a stable technique with a low risk of dislocation either from suture dehiscence (suture breakage or loosening) or suture erosion (suture degradation or wear), making it a reliable and durable option for intraocular lenses (IOL) fixation. Dislocation of rigid IOLs is managed conventionally by removing the IOL through a large sclerocorneal section and refixing the same lens or tucking another IOL into the sclera. The procedure described here is a modified ab-externo 4-exit 2-knot technique, wherein the dislocated SSFIOL can be refixated with a closed globe maneuver without removing the entire IOL. The eyelet of the haptic is exteriorized through a small limbal incision, and sutures are replaced at both ends. The IOLs refixated using this technique showed good centration postoperatively. Closed globe refixation of rigid IOLs can be easily performed with minimal or no complications. Minimal tissue handling and early postoperative recovery are advantages over conventional IOL removal and re-surgery.