Technique for Scleral Fixation of Traumatic Subluxation of IOL

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Presentation transcript:

Technique for Scleral Fixation of Traumatic Subluxation of IOL Arie Marcovich MD Cornea Service, Kaplan Medical Center, Rehovot No Financial Interest

Purpose: To present a technique for repositioning of subluxated IOL to the anterior chamber after blunt trauma

A 73 year-old woman was struck by tennis ball in OS The IOL subluxated to the anterior chamber On examination: BCVA 20/200 IOP 16 mmHg Fundus - Normal IOL type: Hydrophilic acrylic B-lens (Hanita, Israel)

Two opposing paracenteses are performed Sodium hyaluronate 1% is injected to the anterior chamber

Double arm polypropylene 10-0 suture on straight needles passed above and below the subluxated haptic to opposite paracentesis Suture used: Prolene® 10-0 Ethicon STC – 6, Johnson & Johnson, Belgium

The upper needle is inserted back below haptic and drawn out through opposite paracentesis

The needle is reinserted above haptic and drawn out through opposite paracentesis forming a loop around haptic

The haptic and optic are pushed below iris with a Sinskey hook

The needles are guided out through the sclera with a 27 gauge needle Scleral fixation is performed under a flap

One month postoperatively OS BCVA 20/40 Ref: - / -1.5 x 160 IOP 13 mmHg IOL centered

Conclusions: This technique enables to fixate the haptic of a hydrophilic acrylic IOL through corneal paracenteses Scleral fixation is achieved under a flap Anterior subluxation of IOL can be managed easily and atraumatically