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    4-Flanged Technique with a Foldable IOL

    Editors' Choice
    Cataract/Anterior Segment, IOLs and Implantation, New Technology and Instruments

    In this clinical video, Dr. Sergio Canabrava introduces a novel sutureless 4-flanged technique for scleral fixation of an IOL, using a foldable IOL and an IOL punch. This technique, which is an iteration of Dr. Canabrava's novel 4-flanged intrascleral IOL fixation, is based on those of Drs. Lewis and Dr Yamanne and uses a 5-0 polypropylene suture to simplify and improve the safety of scleral fixation of a foldable IOL. First, the IOL punch assists the surgeon in the creation of 2 holes in the optic zone on each side of the foldable IOL. A sclerotomy is then 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 hole 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, Dr. Canabrava does not recommend this technique before the completion of further studies to fully confirm its long-term safety profile. 

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