4 Cases of Mdification of Scleral Fixation Using 30 G Needle for Posterior Chamber Intraocular Lens Dislocation

ABSTRACT

PURPOSE: Various methods of scleral fixation for the cases of posterior chamber intraocular lens (PCL) dislocation or subluxation into the vitreous cavity had been developed, and in the recent year a modification of internal scleral fixation using a hollow-bore needle has been introduced. The authors endeavored to evaluate clinical usefulness of the method. METHODS: The study was conducted for four cases of PCL dislocation or subluxation. A 10-0 polypropylene suture was threaded up the internal shaft of a 30 G straight needle and retrieved. The needle containing this suture was then inserted through the bed of the partial-thickness scleral flap 1.5 mm posterior to the limbus. The loop of suture was hooked with haphic of PCL. After the needle was retracted, the haptic was captured and the suture was tied to the sclera. The same maneuver was performed for the haptic in the opposite side. RESULTS: Except for pars plana vitrectomy, time taken for the above procedure was 10~15 minutes. Postoperatively induced astigmatism of all 4 cases were less than 3 diopters on the second postoperative day. No specific complication associated with this procedure was noted. IOL remained stable without tilting or rotation 18 months after procedure. CONCLUSIONS: This modified internal scleral fixation technique must be a convenient and effective procedure for repositioning posteriorly dislocated PCL.