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Scleral Suture Fixation of Dislocated Posterior Chamber Intraocular Lens: Modification for Tapered Haptics

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LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/IAE.0000000000002900

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intraocular lens dislocation; intraocular lens repositioning; intraocular lens scleral fixation; one-piece acrylic intraocular lens; pars plana vitrectomy

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This study presents a surgical modification technique for repositioning and scleral fixation of one-piece acrylic intraocular lenses with tapered haptics. The modified technique involves looping the haptic at its proximal, notched junction to the optic using a polypropylene suture and internalizing the suture knot. Three consecutive cases were reviewed and showed adequate lens centration at 3 months of follow-up. The technique provides an alternative to lens exchange.
Purpose:To present a surgical modification to a previously published technique that allows repositioning and scleral fixation of one-piece acrylic intraocular lenses with tapered haptics.Methods:A retrospective review of three consecutive cases.Results:Our technique modification enables repositioning using scleral suture fixation of one-piece intraocular lenses with tapered haptics by looping the haptic at its proximal, notched junction to the optic with the polypropylene suture. The suture knot is internalized which effectively suspends the intraocular lens and allows for better adjustment of the intraocular lens centration. Two cases were endocapsular dislocations; the third case was dislocated extracapsularly due through a posterior capsule rupture. All showed adequate lens centration at 3 months of follow-up. One case had suffered a vitreous hemorrhage a month postoperatively that is clearing.Conclusion:Repositioning using scleral fixation of one-piece intraocular lenses with tapered haptics is possible with a minor technique modification. This offers an alternative to intraocular lens exchange.

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