Posters

Intrascleral fixation of the iris hooks for sutureless transcleral capsular bag fixation in patient with zonular dialysis

Poster Details

First Author: R. Karadag UNITED STATES

Co Author(s):    U. Sari   H. Bayramlar   M. Unluzeybek              

Abstract Details

Purpose:

We describe a technique that uses iris hooks to obtain transscleral fixation of the capsular bag.

Setting:

A zonular dialysis was observed during phacoemulsification surgery in an eye with pseudoexfoliation of a 73-year-old man extending from 9 to 3 o’clock hours at Istanbul Medeniyet University Goztepe Research and Training Hospital, Istanbul, Turkey. The surgery was completed using capsule tension ring and IOL implantation into the bag.

Methods:

At the end of the surgery, the IOL was seen as centralized. On 1st post-operative day, dislocation of the capsule-IOL complex, and vitreous in the anterior chamber was observed. Anterior vitrectomy was performed. Despite the fitting of the CTR previously, we thought that it had passed to the behind of the posterior capsule through a defect in the posterior capsule. Therefore, we planned to hang it with the aid of the anterior capsule, without interfering with the posterior capsule.

Results:

After the conjunctival incision, two scleral flaps were formed. Scleral tunnels were formed, 2mm from the limbus and parallel to the limbus and 3mm long. Sclerotomies were created under the scleral flaps. Iris hooks were sent to the posterior chamber; the anterior capsule was captured and pulled by the iris hooks resulting in the IOL adopting an appropriate position. The tips of the iris hooks were clipped and implanted into the scleral tunnels. Because the iris hooks had a thick and material memory, a 10.0 nylon suture was fixed to the scleral bed. The scleral flaps and conjunctiva were sutured.

Conclusions:

It was observed that one of the iris hooks had loosened at the first-week post-operative examination but that the IOL had centralized. The loosened hook was removed. No complications were witnessed during the patient’s 12 months’ observation period. At the patient’s final examination, the refractive defect was determined to be -0.50 -1.50 X 70 and due to a retinal problem (a dry type of age-related macular degeneration), corrected visual acuity was 0.7 Snellen.

Financial Disclosure:

NONE