Modified Scleral Suture Fixation Technique for Foldable IOL with Fenestrations in the Proximal Part of the Haptics

Abstract

To present a modified surgical technique for scleral suture fixation of a new foldable intraocular lens (IOL) design with fenestrations in the proximal part of the haptics. An experimental model of a double continuous-loop 4-point scleral suture fixation of IOL with fenestrations in the proximal part of the haptics showed that with conventional techniques, the lens is located in a horizontal plane 90° to the expected iris plane. To achieve proper IOL positioning, we modified the technique so as to perform 2 needle passes through the sclera for each haptic in the same meridian, resulting in the external part of the suture being radial to the limbus. The technique was performed in 14 eyes. Mean follow-up time was 9.8 months. In all cases, the lens was successfully implanted through clear corneal tunnel incision and the scleral fixation, as mentioned above, was performed with the use of Hoffman scleral pockets. Good centration of the IOLs without signs of tilt was achieved. It is possible to decrease the risk of tilt of the IOL with fenestrations in the proximal part of the haptics by modifying the technique so that the 2 needle passes through the sclera for each haptic are done in the same meridian, resulting in a layout of the external part of the suture being radial to the limbus.