Modified Surgical Technique for Transscleral Fixation of a Single-Piece Acrylic Intraocular Lens in the Absence of Capsular Support

ABSTRACT

PURPOSE: To introduce a new surgical method of transscleral intraocular lens (IOL) fixation using a foldable, single-piece acrylic IOL with 4 loop haptics and to report the surgical results. METHODS: After a single-piece acrylic IOL with 4 loop haptics was injected into the anterior chamber and positioned on top of the iris diaphragm, a 10-0 Prolene STC-6 straight needle and a 27-gauge needle were used to string the prolene thread through the haptic openings from front to back fixating the IOL to the sclera, resulting in a transscleral "1 loop 4 points" fixation. Twenty-eight eyes of 28 patients who had received transscleral fixation via this new technique were retrospectively reviewed. The best corrected vision acuity (BCVA) was measured after a postoperative period of at least 6 months. Intraoperative and postoperative complications were investigated. RESULTS: In 27 out of 28 eyes (96.4%), the postoperative BCVA was better than 0.5 (Snellen chart). The only complication found was 1 case of choroidal detachment (3.6%). CONCLUSIONS: The new transscleral "1 loop 4 points" fixation technique of a foldable, single-piece acrylic IOL in the absence of capsular support is an easy procedure and reduces surgical time and hastens visual rehabilitation due to excellent IOL positioning stability. Additionally, the technique described in the present study may be a safe procedure with minimal complications.