scholarly journals Tram-Track Suture Technique for Pupillary Capture of a Scleral Fixated Intraocular Lens

2016 ◽  
Vol 7 (2) ◽  
pp. 290-295 ◽  
Author(s):  
Sung In Kim ◽  
Kiseok Kim

Purpose: To report a new technique using tram-track suture for pupillary capture of a scleral fixated posterior chamber intraocular lens (PC-IOL) to reposition the tilted IOL. Methods: In this prospective interventional case series, we describe a tram-track suture for pupillary capture of a scleral fixated PC-IOL. A long straight needle with double-armed 10-0 polypropylene is passed behind the iris and just above the optic portion (tilted forward) of the IOL. The other straight needle with double-armed 10-0 polypropylene is passed just below the optic portion (tilted backward) of the IOL. After the IOL is repositioned properly, the polypropylene sutures are gently pulled and tied. Results: Four eyes of 4 patients underwent tram-track suture for pupillary capture of a scleral fixated PC-IOL. No intra- or postoperative complications were noted, and no pupillary captures were detected during the follow-up period. Conclusions: The tram-track suture technique provides good centration and stability of a PC-IOL. This technique is an easy and effective way to reposition pupillary capture of an IOL. Further, it is also minimally invasive as it maintains a closed system.

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ke Lin ◽  
Zhixiang Hu ◽  
Zhong Lin ◽  
Tianyu Chen ◽  
Yongping Tang ◽  
...  

Abstract Background To report a new technique for iris capture of the posterior chamber intraocular lens (IOL) implanted in patients with a posterior capsule defect. Methods In this retrospective case series, a rectangular loop ciliary body suture technique was performed to rectify iris capture. The suture passes between the IOL and iris in a direction perpendicular to the iris edge capturing the IOL. Results A total of three IOLs with iris capture underwent a rectangular loop suture technique. No recapture was observed postoperatively. In one case, large astigmatism appeared after the surgery but recovered at 1 month post operation. No further complications were found. Conclusions The rectangular loop suture technique is an effective, convenient, and minimally invasive method for iris capture of the IOL.


2021 ◽  
pp. 247412642097887
Author(s):  
Gregg T. Kokame ◽  
Tarin T. Tanji ◽  
Jase N. Omizo

Purpose: We report the longest follow-up to our knowledge of stable scleral fixation of a posterior chamber intraocular lens (PC IOL) with 10-0 polypropylene sutures. Methods: A retrospective review is presented of a case with more than 30 years’ follow-up after performing sutured scleral fixation with 10-0 polypropylene suture using 2 sutures tied together under a scleral flap. One suture was a cow-hitch looped around the haptic, and the other suture was passed through the sclera to create the scleral fixation. Results: The scleral fixation with 10-0 polypropylene suture knots for both haptics of the PC IOL allowed central optic positioning with excellent vision for more than 30 years without suture breakage. Conclusions: Polypropylene sutures for scleral fixation of PC IOLs remained stable for more than 30 years with central positioning of the PC IOL, without exposure of the fixation suture knots through the conjunctiva, and without suture breakage.


2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Zhizhong Wu ◽  
Caijuan Liu ◽  
Yanhui Xu ◽  
Wei Dong ◽  
Zhimin Chen

Purpose. To evaluate the short-term safety and efficacy of a novel approach of utilizing the 9-0 looped polypropylene suture with double knots buried into the scleral groove and the scleral tunnel to minimize the risk of the suture erosion and suture knot exposure. Design. Clinical-based retrospective study. Methods. Records of consecutive patients who had anterior vitrectomy and scleral-fixated posterior chamber intraocular lens (IOL) implantation between July 2018 and April 2020 with a minimum follow-up of 3 months were reviewed. Results. This study enrolled a total of 21 eyes from 20 patients (15 male). These patients had a mean age of 58.52 ± 8.55 years and were followed for an average of 1.08 ± 0.58 years postoperatively. Best-corrected visual acuity (BCVA) improved from a preoperative mean of 0.43 ± 0.41 logMAR to a significantly higher mean 3-month postoperative value of 0.09 ± 0.21 logMAR (Z = -3.35, p < 0.01 ). There were no statistical differences between the preoperative and postoperative corneal endothelial cell density ( p = 0.71 ). The postoperative complications included transient increased intraocular pressure in 5 eyes (24%). No other complications were detected during the follow-up. Conclusions. The modified technique proposed is a safe, effective, and reliable approach resulting in good visual outcomes. Our procedure might have the potential benefit to avoid suture-related complications in scleral-fixated IOL implantation. Trial registration. Retrospective case series study, not applicable.


2019 ◽  
Vol 30 (5) ◽  
pp. 985-990 ◽  
Author(s):  
Maurizio Postorino ◽  
Alessandro Meduri ◽  
Leandro Inferrera ◽  
Giuseppe Tumminello ◽  
Miguel Rechichi ◽  
...  

The aim of this article is to report the results of an innovative technique for a scleral fixation of a posterior chamber intraocular lens using our new modified technique. We retrospectively reviewed the medical records of 15 eyes of 15 patients who underwent sutureless intrascleral intraocular lens fixation using our modified technique. We used a 23-gauge knife to perform sclerotomy and create two parallel scleral pockets for the haptics. The mean follow-up period was 3 years (3 ± 1). No complications were detected during the follow-up period. The creation of two parallel scleral pockets, parallel to the limbus, greatly simplifies the introduction of intraocular lens haptics.


2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Sun Jung Eum ◽  
Myung Jun Kim ◽  
Hong Kyun Kim

Purpose. To evaluate surgical efficacy of in situ refixation technique for dislocated posterior chamber intraocular lens (PCIOL).Methods. This was a single-center retrospective case series. 34 patients (34 eyes) who underwent sclera fixation for dislocated IOLs combined with vitrectomy were studied. Of 34 eyes, 17 eyes underwent IOL exchange and the other 17 eyes underwent in situ refixation.Results. Mean follow-up period was 6 months. Mean logMAR best corrected visual acuity (BCVA) was not significantly different between the groups 6 months after surgery (0.10±0.03in the IOL exchange group and0.10±0.05in the refixation group;p=0.065). Surgically induced astigmatism (SIA) was significantly lower in the refixation group (0.79±0.41) than in the IOL exchange group (1.29±0.46) (p=0.004) at 3 months, which persisted to 6 months (1.13±0.18in the IOL exchange group and0.74±0.11in the refixation group;p=0.006). Postoperative complications occurred in 3 eyes in the IOL exchange group (17.6%) and 2 eyes in the refixation group (11.8%). However, all of the patients were well managed without additional surgery.Conclusion. The in situ refixation technique should be preferentially considered if surgery is indicated since it seemed to produce a sustained less SIA compared to IOL exchange.


2007 ◽  
Vol 17 (4) ◽  
pp. 660-665 ◽  
Author(s):  
S. Moghimi ◽  
M. Riazi Esfahani ◽  
M. Maghsoudipour

Purpose To evaluate the efficacy and safety of aniridia posterior chamber intraocular lens (PCIOL) in traumatic aniridia and aphakia in vitrectomized eyes. Methods Four aphakic patients with traumatic aniridia and previous pars plana vitrectomy (PPV) due to posterior segment trauma enrolled in the study, and had secondary implantation of an aniridia PCIOL. Two patients were men and two women with mean age of 39.25 years. Complete ophthalmic examinations, including preoperative and postoperative visual acuity in dark and light, glare disability, visual function (using VF-9 questions modified from VF-14), stereopsis, and contrast sensitivity in 3, 6, 12, and 18 cycle per degree frequencies, were done for all patients. Postoperative intraocular pressure (IOP), IOL centration, and intraocular inflammation were monitored. Mean follow-up was 12.25 months (range 7 to 15 months). Results Visual acuity improved in all four patients, especially in the light. Glare was subjectively reduced in all of them. Stereopsis was measurable in three of them postoperatively. Contrast sensitivity improved in all patients, especially in brightness and lower frequencies. All four eyes had improved VF-9. All eyes achieved the desired anatomic results. Two cases developed elevated IOP early after surgery. In one eye, IOP elevation was transient and controlled with antiglaucoma medication, but the other eye, which had secondary glaucoma from previous trauma, required cyclophotocoagulation for the IOP to be controlled. No patient developed chronic uveitis or redetachment. Conclusions The aniridia PCIOL can overcome aphakia, reduce glare, and increase visual function, contrast sensitivity, and stereopsis in vitrectomized eyes with traumatic aniridia. Although this kind of IOL appears safe, some disadvantages are secondary glaucoma and reduced visibility of peripheral fundus, and caution should be used in its implantation until more patients with longer follow-up are studied.


2019 ◽  
Vol 4 (2) ◽  
pp. 119-124
Author(s):  
H. Russell Day ◽  
Alia K. Durrani ◽  
Stephen J. Kim ◽  
Shriji Patel

Purpose: The authors aim to describe the visual outcomes and postoperative complications of concurrent pars plana vitrectomy and scleral-fixated intraocular lens (IOL) placement using Gore-Tex suture. Methods: A retrospective review of medical records was performed on 27 eyes of 27 patients undergoing concurrent pars plana vitrectomy and scleral-fixated IOL with Gore-Tex suture. Outcome measures were change in preoperative and postoperative visual acuity, final manifest refraction, and incidence of intraoperative and postoperative complications. Results: The mean age was 69.2 ± 11.3 years; there were 16 male patients (59%). The duration of follow-up ranged from 33 to 576 days with a mean of 200 ± 143 days. All patients received Bausch + Lomb Akreos AO60 IOL. The overall mean best-corrected visual acuity in Snellen equivalent improved from 20/276 preoperatively to 20/44 postoperatively ( P < .001). The mean postoperative manifest spherical equivalent refraction was –0.35 ± 1.34 diopters (D). Seventy-five percent of eyes were ± 1.0 D of target refraction. Postoperative complications included corneal edema (26.0%), ocular hypertension (25.9%), hypotony (7.4%), cystoid macular edema (7.4%), vitreous hemorrhage (7.4%), and hyphema (3.7%). No cases of suture breakage, IOL dislocation, retinal detachment, or uveitis–glaucoma–hyphema syndrome were identified. Conclusions: The use of Gore-Tex suture for posterior chamber IOL fixation resulted in favorable outcomes. No suture-related complications occurred during the follow-up period. Final refraction in this setting is typically within ± 1.0 D of target.


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