Clinical Ophthalmology (Jul 2018)
In-and-out technique for intraocular lens scleral fixation
Abstract
Jung Yeol Choi,1 Young Keun Han2,3 1Department of Ophthalmology, Jeju National University Hospital, Jeju, South Korea; 2Department of Ophthalmology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea; 3Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea Abstract: We describe a modified scleral fixation method to facilitate the good centration and adequate tension of sutures at both ends with addition of an internal fixation knot that reduces decentering of the IOL in a patient with postsurgical aphakia. Using an ab externo suture technique to fixate the haptics to the scleral wall, an additional loop knot is tied 1 mm next to the fixation knot at the haptic. In the technique, an internalized suture and an additional suture knot is tied while holding it close to the fixation knot at the haptic using a needle holder or McPherson forceps. The externalized sutures are secured by taking a bite of transclera and tying the suture to itself. This technique is simple and easy, and adds an internal check valve to prevent excessive pull and decentering of the intraocular lens at one side. The internal check valve also serves as a criterion for the point of fixation at each end. Keywords: modified technique, intraocular lens scleral fixation, postsurgical aphakia
