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. 2024 Feb 22;38(2):163-167.
doi: 10.4103/sjopt.sjopt_119_23. eCollection 2024 Apr-Jun.

Scleral-fixated intraocular lens implantation with "irregular, knotless, zigzag-shaped scleral tunnel suture technique" combined with pars plana vitrectomy or anterior vitrectomy

Abuzer Gunduz  1 , Emrah Ozturk  1 , Cem Cankaya  2 , Pamuk B U Atas  3
Affiliations

Scleral-fixated intraocular lens implantation with "irregular, knotless, zigzag-shaped scleral tunnel suture technique" combined with pars plana vitrectomy or anterior vitrectomy

Abuzer Gunduz et al. Saudi J Ophthalmol. .

Abstract

Purpose: This study aims to introduce a new suture method and report surgical outcomes of patients who underwent scleral-fixated intraocular lens (SF-IOL) implantation combined with either pars plana vitrectomy (PPV) or anterior vitrectomy (AV).

Methods: Twenty-three eyes performed SF-IOL implantation combined with PPV (Group 1), and 34 eyes performed SF-IOL implantation combined with AV (Group 2) were included in the study prospectively. The SF-IOL, either polymethyl methacrylate or foldable IOL, was sutured into the sclera using PC-9 sutures in an irregular, knotless, and zigzag-shaped manner. The scleral tunnel was approximately 12-15 mm long, with at least four sharp edges. Suture tips were trimmed within the scleral tunnel. Postoperative outcomes and complications were evaluated.

Results: Both groups showed no complications such as suture tip expulsion, suture reaction, IOL dislocation, or increased intraocular pressure during postoperative visits. Group 1 exhibited a statistically significant improvement in visual acuity compared to preoperative values (P = 0.036 for the 1st month, <0.001 for the 3rd month). Similarly, Group 2 demonstrated a statistically significant improvement in visual acuity compared to the preoperative period (P = 0.001 for the 1st month, <0.001 for the 3rd month).

Conclusion: The "irregular, knotless, and zigzag-shaped scleral tunnel suture technique" yielded favorable results in terms of IOL stability and visual acuity. This technique can be safely employed in patients undergoing SF-IOL implantation combined with PPV or AV.

Keywords: Anterior vitrectomy; Z-suture method; aphakia; pars plana vitrectomy; scleral-fixated intraocular lens implantation.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
The postoperative appearance of irregular, knotless, andzigzag-shaped scleral tunnel suture technique in a patient (The suture is visible within the circle)
Figure 2
Figure 2
Schematic diagram for the steps (a-d) of irregular, knotless and zigzag-shaped scleral tunnel suture technique, black arrow: Suture needle passing direction, red arrow: Area of scleral thinning
See this image and copyright information in PMC

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