FEB 03, 2015
The authors describe a technique that uses a capsular hook to obtain sutureless fibrin glue–assisted transscleral fixation of the capsular bag.
While this sounds like a good idea, it is not available in the United States.
This new technique can anchor the capsular bag to the sclera both intraoperatively and postoperatively. The authors say it is easy to perform and can be done quickly. Combined with a standard capsular tension ring (CTR), it provides vertical and horizontal stability, and it eliminates issues associated with suture fixation of CTRs and capsular tension segments.
To perform the procedure, they pass the hook through a sclerotomy created under a scleral flap and engage the hook with the capsulorhexis rim, providing scleral fixation intraoperatively and postoperatively. They expand the capsular fornix with a standard CTR. Then they tuck the haptic of the hook into a scleral tunnel for postoperative fixation and close the scleral flap with fibrin glue.
The authors used the technique in seven patients who were followed for a mean of four months. Grade 2 cells and flare were seen in three cases that responded well to steroids. No other postoperative complications were encountered. All IOLs were well centered without tilt.
They say that these initial intraoperative and postoperative results are promising, although further studies with more patients and longer follow-up are required to assess the long-term safety and stability of the glued capsular hook.