A loop and sliding knot technique for scleral fixation of Akreos Adapt AO intraocular lens

Purpose: This study describes a novel loop and sliding knot technique for the scleral fixation of the Akreos Adapt AO intraocular lens (IOL). Methods: A 27G needle was inserted into the eye from two ipsilateral fixation sites, and passed through the IOL eyelet, exiting from the same limbus incision. The suture was pulled out and inserted into the needle to form a loop. A 26G needle guided the suture to pass through the superficial sclera between the two fixation sites. Part of the suture was pulled out and tied to the free suture to form a sliding knot. The knot was then buried in the scleral tunnel. Results: A total of 12 patients (12 eyes) underwent this technique. The logarithm of the minimum angle of resolution (logMAR) for preoperative corrected visual acuity was 0.75 ± 0.62 (Snellen 20/112), which improved to 0.25 ± 0.24 (Snellen 20/35) at the final follow-up. The mean postoperative posterior chamber IOL tilt was 2.64 ± 1.28°. There were no cases of pupillary capture or suture-related complications during the follow-up period. Conclusion: The loop and sliding knot technique offers a simple and minimally invasive method for the four-point fixation of the Akreos Adapt AO IOL.