Novel 4-Flanged Intrascleral IOL Fixation

In this clinical video, Dr. Sergio Canabrava introduces a novel sutureless 4-flanged technique for scleral fixation of an IOL. Inspired by the Lewis scleral fixation and the Yamane technique, it uses a 5-0 polypropylene suture to simplify and improve the safety of scleral fixation of single-piece non-foldable IOLs. First, a sclerotomy is made transconjunctivally, approximately 2.0 mm from the limbus, using a 26-gauge needle. A 5-0 polypropylene monofilament is placed into the needle’s lumen through the corneal incision. This is repeated 180º from the initial sclerotomy. The sutures are then passed through the IOL eyelets and heated to create flanges. The IOL is then placed in the sulcus and positioned using the externalized sutures. Finally, 2 more flanges are created and are buried into the scleral tunnel. Although preliminary studies suggest this technique is stable, further studies are necessary to fully confirm it's long-term safety profile.

Relevant Financial Disclosures: Dr. Sergio Canabrava has a patent pending on the foldable IOL created for the 4-flanged technique.