Novel Method for Scleral Fixation of 1-Piece IOLs

The authors show a novel technique for suturing a dislocated foldable acrylic lens (Alcon SN60). After a pars plana vitrectomy, the posteriorly dislocated IOL is grasped with a retinal forcep and elevated into the anterior chamber. The first haptic is externalized with a second retinal forcep through a small 2.2mm clear cornea incision. While holding the haptic with a pair of forceps, 8.0 Gore Tex suture is carefully passed by needle through the insertion of the haptic at the junction with the optic. Next, the needle is cut. The 2 inferior sclerotomy sites, previously marked, should now be opened by bare trocar. The Gore-Tex suture and haptic are reinserted into the eye, with the 2 ends of the suture being fed by handshake technique through the superior and inferior sclerotomies on one side of the eye. The second suture for the contralateral side of the eye is now placed in an identical manner. Although the lens was initially stable, the surgeons ended up doing a lens exchange as the IOL did not remain centered over time. It is unclear if it was the technique or simply how this one case evolved.

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