Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Jun;26(6):788-91.
doi: 10.1038/eye.2012.19. Epub 2012 Mar 2.

Trocar-assisted sutureless intrascleral posterior chamber foldable intra-ocular lens fixation

Y Totan  1 , R Karadag
Affiliations

Trocar-assisted sutureless intrascleral posterior chamber foldable intra-ocular lens fixation

Y Totan et al. Eye (Lond). 2012 Jun.

Abstract

Purpose: We report a novel technique characterized by sutureless scleral fixation of three-pieces foldable intraocular lens (IOL) using 25-gauge transconjunctival sutureless vitrectomy (TSV) trocars in patients with insufficient posterior capsule support.

Materials and methods: We performed this technique on the eight eyes of the seven patients. The scleral tunnels (STs) are prepared by insertion of the 25-gauge TSV microcannulas using the trocars, and anterior vitrectomy is performed through the clear corneal paracentesis with the aid of anterior chamber maintainer (ACM). Finally, the three-piece foldable IOL haptics are incarcerated into the prepared STs.

Results: The patients were followed up 5-8 months. None of the patients had complications such as postoperative endophthalmitis, glaucoma, IOL tilt or decentralization, and retinal detachment. Injection of a foldable IOL through a clear corneal small incision also contributes the less surgical-induced astigmatism.

Conclusion: The presented novel sutureless scleral IOL fixation technique may provide minimal trauma to the surrounding tissues, good IOL stabilization decreasing the incidence of IOL tilt along with shorter operation time, and postoperative quiet eye.

PubMed Disclaimer

Figures

Figure 1
Figure 1
(a) Marking of the peripheral cornea 180° from each other; (b, c) preparing of two 10° transconjunctival STs, 1.5 mm from and parallel to the limbus; (d) performing of the vitrectomy after the placement of the anterior camera maintainer.
Image 1
Image 1
Preparing of two transconjunctival 3mm ST, 1.5mm from and parallel to the limbus.
Figure 2
Figure 2
(a, b) Implantation of IOL with the injector.
Figure 3
Figure 3
(a) Grasping of one of the haptic with the vitrectomy forcep in the pupillary area; (b) the removal of the grasped haptic from the ST with the transconjunctival vitrectomy trocar; (c) the appearance of the haptic exiting from the ST; (d) removing of the other haptic from the ST with the transconjunctival vitrectomy trocar.
Figure 4
Figure 4
(a) Placement of the secure suture to the haptics; (b) the postoperative appearance.
Figure 5
Figure 5
Ultrasound biomicroscopy image of the 3rd month after surgery.
See this image and copyright information in PMC

References

    1. Smiddy WE. Dislocated posterior chamber intraocular lens; a new technique of management. Arch Ophthalmol. 1989;107:1678–1680. - PubMed
    1. Nabors G, Varley MP, Charles S. Ciliary sulcus suturing of a posterior chamber intraocular lens. Ophthalmic Surg. 1990;21:263–265. - PubMed
    1. Azar DT, Wiley WF. Double-knot transscleral suture fixation technique for displaced intraocular lenses. Am J Ophthalmol. 1999;128:644–646. - PubMed
    1. Baykara M, Ozcetin H, Yilmaz S, Timuçin OB. Posterior iris fixation of the iris-claw intraocular lens implantation through a scleral tunnel incision. Am J Ophthalmol. 2007;144:586–591. - PubMed
    1. Dick HB, Augustin AJ. Lens implant selection with absence of capsular support. Curr Opin Ophthalmol. 2001;12:47–57. - PubMed