Editors' Choice
    Cataract/Anterior Segment

    In this video, Dr. Altan Ozcan demonstrates fixation of an iris-IOL complex by using the double-flanged first technique described by Dr. Canabrava. First, the sclerotomy sides are marked on the conjunctiva 2 mm apart from the limbus and additional marks are added to the side where scleral tunnel will be created. The 5-0 polypropylene suture end is passed through the first eyelet of a iris-IOL complex (Reper) and heated by the thermocautery to create the first flange and is then repeated for the other 2 eyelets. Then a 27-gauge hypodermic needle is used to perform transconjunctival sclerectomy. One end of the 5-0 polypropylene suture is pushed into the needle’s inner cavity and the suture is externalized and heated to create the second flange. This is repeated with other sutures. The iris-IOL complex is folded and introduced into the anterior chamber. The sutures are cut 2 mm from their base and heated to form last final second flanges, which will be inserted into the sclera tunnel. The Canabrava technique simplifies and improves the fixation of iris-IOL complex into the sclera. It has a low cost and gradual learning curve, which does not require scleral flaps or knots. The main issue related with this surgery is the insertion of the flanged 5-0 polyproplene monofilament suture into the sclera. It is better to insert it into a tunnel instead of direct burying in terms of stability and safety. The size of flange should be arranged for proper insertion.

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