Intrascleral capture of knots without conjunctival opening and scleral exposing in scleral reinforced suture fixation of intraocular lens: new technique

Purpose. Development of new technique for scleral reinforced suture fixation of intraocular lens (IOL) in the absence of capsule support with intrascleral capture of knots without conjunctival opening. Material and methods. Three patients with «IOL-capsular bag» complex dislocation into the vitreous cavity underwent scleral fixation of the IOL in the new modification. The IOL was placed into ciliary sulcus on two 9-00 double polypropylene sutures brought out transsclerally without conjunctival opening. Both sutures were passed intrasclerally for 3.0 mm, sticking each of needles into the sclera at the points of sutures exit from conjunctiva, and brought out through conjunctiva. Threads were cut, leaving 2.0 mm free ends, and knots (2-1-1) were tied with the tension necessary to capture them in the scleral canals. At the points of exit of threads' ends from the conjunctiva, additional needles with looped double threads were sticked again, passed intrasclerally for 3.0 mm and were brought out through conjunctiva; ends of the threads fixing the IOL were captured in loops and dipped in the scleral canals. Results. During the follow-up, position of the IOL was correct, sites of neddles' sticks into the conjunctiva were epithelized, and no tendency to erosion of intrascleral threads was observed. Conclusions. New modification of scleral fixation of IOLs is technically simple, does not require conjunctival opening. It involves the use of double suture, which increases the durability of fixation. Technique can be used for fixation of any IOL model, as well as artificial irido-lens diaphragm, intracapsular ring or intracapsular segment. Key words: scleral fixation of intraocular lens.