A Novel Intraocular Lens and Capsular Bag Complex Suspension Technique for Repositioning Late In-the-Bag Intraocular Lens Dislocation.

Abstract

Purpose: To present a novel in situ scleral suspension surgical technique for the management of dislocated intraocular lens (IOL)-capsular bag complex and to evaluate its clinical efficacy.

Patients and methods: Patients who underwent the novel in situ scleral suspension technique for in-the-bag IOL dislocation at the Department of Ophthalmology, Shanghai General Hospital, between February 2024 and February 2025, were included. The technique involves performing a scleral puncture 3 mm posterior to the limbus, passing a single suspensory suture twice through the fibrotic capsular tissue of the dislocated IOL-capsular bag complex, and securing the suture to the sclera with a single knot. Preoperative and postoperative uncorrected distance visual acuity (UDVA) and best-corrected visual acuity (BCVA), as well as adverse events, were recorded.

Results: A total of 8 eyes from 8 patients were included. The median preoperative uncorrected distance visual acuity (UDVA), expressed as the logarithm of the minimum angle of resolution (logMAR), was 1.3 (range, 1.0-2.0), improving to 0.56 (range, 0-2.3) at the final follow-up. During the postoperative follow-up period (1 month to 1 year), transient ocular hypertension and uveitis occurred in one patient each, with no other significant adverse events observed, including IOL tilt, decentration, pupillary capture, suture exposure, or vision-threatening macular edema.

Conclusion: This novel in situ suspension technique for in-the-bag IOL dislocation demonstrates enhanced postoperative uncorrected distance visual acuity, a favourable short-term safety profile, simplified procedural steps with minimally tissue trauma, independence from the type of dislocated IOL, and no requirement for specialized instruments or bio-materials. Future studies with extended follow-up are warranted to validate its long-term efficacy and safety.