Transscleral suture fixation of posterior chamber lenses is a popular recent alternative for avoiding the potential complications of anterior chamber lenses and in the absence of sufficient iris support for an anterior chamber lens. If a posterior chamber lens is fixated by only two points in the ciliary sulcus, the lens may tilt relative to the visual axis, causing clinically significant and possibly uncorrectable astigmatism. Described methods of three- or four-point fixation are technically more difficult and can result in an improperly centered lens. A method is described herein that allows stable four-point fixation with precise lens placement using only two sutures. This method also allows the suture knot to be buried in the eye without the use of scleral flaps.
Bergren RL. Four-Point Fixation Technique for Sutured Posterior Chamber Intraocular Lenses. Arch Ophthalmol. 1994;112(11):1485-1487. doi:10.1001/archopht.1994.01090230099029