Modified Four-Point Scleral Suture Fixation Technique for Repositioning a Dislocated Intraocular Lens in the Absence of Capsule Support

Abstract EN

Purpose.

To study the efficacy of a modified four-point fixation technique for the repositioning of a dislocated intraocular lens (IOL) with four eyelets in the absence of capsule support.

Methods.

Four patients with dislocated four-eyelet hydrophilic acrylic IOLs (Akreos AO60) were enrolled.

The modified technique combined four-point fixation with intrascleral sutures and suture burying.

The technique minimized the limbus incision to 1 mm with no externalization of the IOL or its haptics.

Follow-ups included routine ophthalmic examinations, corneal endothelial cell counts, and measurement of IOL tilt and decentration (measured using Pentacam® HR images).

Results.

The IOLs were successfully repositioned in all cases.

After a mean follow-up period of 19.75 ± 7.85 months (range: 8 to 24 months), the patients’ best-corrected vision acuity (BCVA (LogMAR), before: 0.63 ± 0.36, after: 0.58 ± 0.43, P=0.604) and intraocular pressure (pre 13.35 ± 0.85 mmHg, post 14.80 ± 2.03 mmHg, P=0.150) remained unchanged.

Corneal endothelium density decreased about 6.84 ± 2.97%.

In all cases, the IOL was well positioned during the follow-up.

At the final visit, the average IOL tilt was 1.36 ± 0.35° horizontally and 1.31 ± 0.14° vertically.

The average IOL decentration was 0.23 ± 0.12 mm horizontally and 0.18 ± 0.13 mm vertically.

Conclusions.

With this modified technique, dislocated IOLs with four-eyelets could be treated safely with favorable outcomes.