The retrograde suture needle threading technique for in-situ repositioning of dislocated intraocular lenses with eyelets.

Background: Rescuing dislocated intraocular lenses (IOLs) with eyelets after scleral suture fixation presents technical challenges and risks of ocular tissue damage. We propose a novel in-situ rescue technique for repositioning dislocated IOLs with fixation eyelets. This approach avoids large incisions, accommodates dislocations in any direction, and offers a safer, more efficient alternative to traditional methods.

Methods: The technique was performed on four patients with dislocated IOLs following scleral suture fixation. Under retrobulbar anesthesia, a retrograde suture-guided approach was employed. A double-armed polypropylene suture was introduced retrogradely into the eye via a puncture site. The suture arms were threaded through the fixation eyelet of the IOL haptic. One arm was then cut and hooked out through the eyelet. The broken ends of the two sutures were tied together. The IOL was adjusted to its proper position, and the suture was tightened to secure it to the sclera.

Results: All four patients underwent successful in-situ IOL refixation without intraoperative complications. Postoperative examinations confirmed well-centered IOLs in all cases. Postoperative vision has significantly improved compared to preoperative vision. Over a follow-up period of 11-36 months, no redislocation or major complications were observed.

Conclusion: This in-situ rescue technique provides a safe, effective, and straightforward solution for fixing dislocated perforated IOLs. Its simplicity and positive outcomes position it as a promising option for managing these complex cases.