Scleral fixation of hydrophobic acrylic intraocular lenses using a suture burial technique

Abstract

The procedure involved an ab-externo scleral fixation technique using a double-armed 10-0 polypropylene suture with straight needles that require no scleral flaps. The IOLs are sutured to the sclera, the free suture ends are tied to the suture loops, and they are buried together under the sclera. Forty eyes of 37 patients were included. Postoperative complications are IOL capture in five eyes (12.5%), a significant IOL tilt in one eye (2.5%), recurrent UGH (uveitis-glaucoma-hyphema) syndrome in two eyes (5%), glaucoma in three eyes (7.5%), suture exposure in two eyes (5%) and IOL drop due to haptic breakage in one eye (2.5%). The technique can be effectively used for the refixation of dislocated hydrophobic acrylic IOLs by temporary haptic externalization through a corneal incision and for the treatment of aphakia with or without penetrating keratoplasty. Surgeons should be aware of the possibility of UGH syndrome due to IOL capture, especially in young eyes.