Selim Doganay, Duygu Erdem, Derya Doganay, Mehmet Omer Kiristioglu
{"title":"Inverted tunnel scleral fixation technique for dropped intraocular lens complex: the double-flanged suture method.","authors":"Selim Doganay, Duygu Erdem, Derya Doganay, Mehmet Omer Kiristioglu","doi":"10.5935/0004-2749.2024-0190","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study is to describe a minimally invasive and atraumatic technique for managing the polypropylene suture-assisted scleral fixation of intraocular lens-capsular bag complex or artificial iris-intraocular lens complex for repositioning late luxated or subluxated intraocular lens-capsular bags and artificial iris-intraocular lens complexes.</p><p><strong>Methods: </strong>In this retrospective and observational study, we evaluated 11 patients, including 10 patients with capsular bag-intraocular lens complex subluxation or luxation into the vitreous cavity and 1 patient with an aniridia-intraocular lens complex. A single senior surgeon performed the procedures. After anesthesia, a 4 × 4 mm conjunctival peritomy was created, and a 6-0 polypropylene suture was passed through the sclera marked 2.0 mm posterior to the limbus. The suture ends were cauterized into a flange under 0.5 mm and inserted inversely into a scleral tunnel, concealed within a 2-mm scleral tunnel to ensure secure intraocular lens positioning.</p><p><strong>Results: </strong>We analyzed 11 patients with dislocated or dropped capsular bag-intraocular lens complexes. The patients' median age was 67 (range 44-78) years, with a median follow-up of 10 (range: 4-16) months. There were 8 (72%) men and 3 (27%) women. Conjunctival peritomy was performed in 4 (36%) patients. Predominantly, preoperative diagnoses indicated 7 (63%) patients with dislocated capsular bag-intraocular lens complexes. The capsular bag-intraocular lens complexes were centralized in all patients, and optical coherence tomography confirmed accurate suture positioning within the sclera. No suture-related complications were observed throughout the follow-up period, and no vision-threatening complications were reported during the postoperative follow-up.</p><p><strong>Conclusions: </strong>Our technique provides a simple, effective solution for treating decentralized or dislocated capsular bag-intraocular lens complexes, eliminating the need for complex interventions such as large corneal wounds, scleral flaps, intraocular lens exchange, and intraocular lens externalization.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 4","pages":"e20240190"},"PeriodicalIF":1.1000,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arquivos brasileiros de oftalmologia","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5935/0004-2749.2024-0190","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: The aim of this study is to describe a minimally invasive and atraumatic technique for managing the polypropylene suture-assisted scleral fixation of intraocular lens-capsular bag complex or artificial iris-intraocular lens complex for repositioning late luxated or subluxated intraocular lens-capsular bags and artificial iris-intraocular lens complexes.
Methods: In this retrospective and observational study, we evaluated 11 patients, including 10 patients with capsular bag-intraocular lens complex subluxation or luxation into the vitreous cavity and 1 patient with an aniridia-intraocular lens complex. A single senior surgeon performed the procedures. After anesthesia, a 4 × 4 mm conjunctival peritomy was created, and a 6-0 polypropylene suture was passed through the sclera marked 2.0 mm posterior to the limbus. The suture ends were cauterized into a flange under 0.5 mm and inserted inversely into a scleral tunnel, concealed within a 2-mm scleral tunnel to ensure secure intraocular lens positioning.
Results: We analyzed 11 patients with dislocated or dropped capsular bag-intraocular lens complexes. The patients' median age was 67 (range 44-78) years, with a median follow-up of 10 (range: 4-16) months. There were 8 (72%) men and 3 (27%) women. Conjunctival peritomy was performed in 4 (36%) patients. Predominantly, preoperative diagnoses indicated 7 (63%) patients with dislocated capsular bag-intraocular lens complexes. The capsular bag-intraocular lens complexes were centralized in all patients, and optical coherence tomography confirmed accurate suture positioning within the sclera. No suture-related complications were observed throughout the follow-up period, and no vision-threatening complications were reported during the postoperative follow-up.
Conclusions: Our technique provides a simple, effective solution for treating decentralized or dislocated capsular bag-intraocular lens complexes, eliminating the need for complex interventions such as large corneal wounds, scleral flaps, intraocular lens exchange, and intraocular lens externalization.
期刊介绍:
The ABO-ARQUIVOS BRASILEIROS DE OFTALMOLOGIA (ABO, ISSN 0004-2749 - print and ISSN 1678-2925 - (ABO, ISSN 0004-2749 - print and ISSN 1678-2925 - electronic version), the official bimonthly publication of the Brazilian Council of Ophthalmology (CBO), aims to disseminate scientific studies in Ophthalmology, Visual Science and Health public, by promoting research, improvement and updating of professionals related to the field.