Novel A-type scleral suture technique for sulcus-fixated intraocular lens tilt

This report describes the first use to the authors' knowledge, of a simple technique for repositioning a tilted intraocular lens (IOL) after scleral fixation. A 76-year-old woman presented with sudden blurred vision in the right eye. She had previously undergone IOL scleral fixation due to traumatic cataract and acute angle-closure glaucoma. IOL tilt was revealed on examination, and repositioning was performed with polypropylene sutures across the pupil from limbus to limbus by forming an A shape to stabilize the IOL and prevent rotation. 6 months after the repositioning surgery, the IOL was well positioned and the patient's corrected distance visual acuity improved from counting fingers to 20/25. This surgical technique was successfully performed for a patient with IOL tilt. It decreased operative time and corneal damage while increasing IOL stability. The procedure was a safe and effective alternative to IOL exchange for a patient with inadequate capsular support.