Abstract
Scleral fixation surgery is a pivotal procedure that depends on the availability of robust and innovative surgical fixation methods. There continues to be a need for innovation in suture fixation techniques, particularly for intraocular lens implantation. We conceived and designed a "knot ball" scleral fixation technique for suture burial in a retrospective sample of 108 patients with primary (n=40) or secondary (n=68) scleral-fixated intraocular lens. Importantly, our technique did not require additional scleral flap or tunnel procedures. We evaluated pre- and postoperative best-corrected visual aquity (BCVA) and postoperative complications. All data were analyzed and compared between groups. The preoperative mean BCVA improved significantly in both groups using the "knot ball" fixation technique (p<0.01). The extent of the improvement in the best-corrected visual acuity and late complications one month post-surgery were not significantly different between the groups (p>0.05). These clinical outcomes were consistent with those described in the ophthalmology literature. A "knot ball" scleral fixation technique is reported; to the best of our knowledge, this is the first report of such a technique, which offers a less invasive and simplified surgical procedure for transscleral fixation of scleral-fixated intraocular lenses. Moreover, the technique appears to display similar effectiveness and safety compared with existing scleral fixation techniques. We suggest that the "knot ball" technique warrants further research focus and clinical evaluation in future studies.
Highlights
Innovation in ophthalmic surgery is an area of intense research in which new technologies or procedural improvements might offer the promise of improved clinical outcomes
In the absence of sufficient capsular support, scle ral-fixated (SF) posterior chamber intraocular lenses (IOLs), anterior chamber IOLs (ACIOLs), iris-claw IOLs, or iris-sutured posterior chamber IOLs are used for surgical treatment of aphakia[1]
The triangular scleral flap is one of the most commonly used techniques worldwide. This technique extends surgery duration, requires more scleral bleeding control during surgery, and atrophy in scleral flaps may occur over time[20]
Summary
Innovation in ophthalmic surgery is an area of intense research in which new technologies or procedural improvements might offer the promise of improved clinical outcomes. In this context, scleral fixation surgery is a crucial procedure which depends on the availability of robust scleral fixation methods. There is a particular need for new approaches in suture fixation techniques for intraocular lens implantation to make the procedures less invasive. Previous studies have suggested that transscleral fixation of posterior chamber IOLs has significant advantages over other implantation techniques in the context of prevention of various complications, including corneal endothelial damage, pupillary block glaucoma, hyphemia, uveitis, iris damage, IOL dislocation, and pseudophakodonesis[2,3,4]. Suture techniques need to cover, bury, or rotate suture knots to prevent suture-related complications[2,3]
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