J Korean Ophthalmol Soc.  2012 Nov;53(11):1609-1614.

Knotless External Fixation Technique for Posterior Chamber Intraocular Lens Transscleral Fixation: A 5-Case Analysis

• Ma DJ
• Kim MK
• Wee WR

Abstract

PURPOSE
To determine whether the knotless technique can be an alternative for the scleral flap-making technique in posterior chamber intraocular lens transscleral fixation when a scleral flap cannot be made.
METHODS
Five patients underwent the knotless technique for posterior chamber intraocular lens transscleral fixation when a scleral flap could not be made. Partial thickness scleral anchoring sutures were repeated three times near the transscleral penetration site in both ends. The end of the anchoring suture was passed under the exposed part of the partial thickness scleral anchoring suture and pulled to adjust the position of the intraocular lens. Then, anchoring sutures were covered with a conjunctival flap. Complications and change of intraocular lens astigmatism were evaluated.
RESULTS
During the 8-month postoperative follow-up period, one case of ciliary body hemorrhage due to intraoperative transscleral penetration and one case of mild intraocular lens tilting owing to the improper tension of the string were observed. Except for one case with a concurrent penetrating keratoplasty, intraocular lens astigmatism showed no significant change during the postoperative follow-up period and no significant difference compared to transscleral fixation with a scleral flap.
CONCLUSIONS
Knotless technique for external fixation of posterior chamber intraocular lens transscleral fixation is a safe and easy technique and may be a good alternative for the scleral flap-making technique in posterior chamber intraocular lens transscleral fixation when a scleral flap cannot be made.

Keyword

Decentration; Intraocular lens astigmatism; Knotless; Tilting; Transscleral fixation

MeSH Terms

Astigmatism
Ciliary Body
Follow-Up Studies
Hemorrhage
Humans
Keratoplasty, Penetrating
Lenses, Intraocular
Sutures

Figure

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  Figure 1 A knotless technique for the external fixation of the transscleral suture (A) The anchoring suture with partial thickness scleral penetration of 10-0 polypropylene (Prolene, Ethicon, Somerville, NJ, USA), (B) Partial thickness scleral penetrations were repeated three times, (C) The end of the anchoring suture was buried under the exposed part of the anchoring suture. (D) Representative slit-lamp photography after the knotless techniques for external fixation of the transscleral suture.

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  Figure 2 Comparison of IOL astigmatism between the external fixation with a knot and the knotless external fixation.

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