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July 1998

Modification of Scleral Suture Fixation Technique for Dislocated Posterior Chamber Intraocular Lens Implants

Arch Ophthalmol. 1998;116(7):967. doi:

We have previously reported1 on a convenient—and our currently preferred—technique for repositioning posteriorly dislocated intraocular lens implants when scleral suture fixation techniques are necessary. We have found this to be quite useful in a variety of cases and have reported the results elsewhere.2 The unique element in this surgical technique compared with that in numerous other reports is the use of a 27-gauge needle that has a hole bored in its bevel (Trek Medical Products, Mukwonago, Wis).3 We have recently learned that this needle will no longer be manufactured. We have modified the technique only by substituting a 58-inch 25-gauge needle for the Trek needle (Figure 1). The technique involves threading the 9-0 polypropylene (Prolene) suture retrograde, up the bore of the needle, to retrieve the end of the suture that is not needled through the hub of the bare needle. As in the other technique, the suture is then inserted through the base of a partial-thickness scleral flap, approximately 1 mm posterior to the limbus; the intraocular lens, grasped at the optic with forceps, is then directed such that the haptic is captured by the resulting suture loop. It is unnecessary to discriminate the orientation of the haptic as it is passed through the loop. The same maneuver (if necessary) is performed for the other haptic.