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The 4 flanged lasso technique for secondary intraocular lens fixation: a retrospective case series

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First Author: R.Biron ISRAEL

Co Author(s):    R. Biron   A. Einan Lifshitz   O. Mahler              

Abstract Details

Purpose:

To report our clinical experience with scleral fixation of capsular bag- Intraocular lens (IOL) complex following secondary IOL subluxation using the 4 flange lasso technique; short term outcomes and practical clinical techniques for success.

Setting:

A retrospective case series

Methods:

Two scleral punctures, 2.0 and 1.5 mm from the limbus were made with a 30-guage needle, below and above the haptic planes respectively. Hand shack technique was used to insert a 6-0 prolen suture into the 30 guage needle and pull it out through the sclera. Low temperature cautery was used to create a flange at the edge of the prolen suture securing it into the sclera and under the conjunctiva.

Results:

Included were 9 patients. Mean age was 82±5.91 and 44% (n=4) were males 77.7% had ocular co-morbidities. 56% of patients had a diagnosed OAG glaucoma, 89.9% had pseudoexfoliation (PXF). The mean follow up time was 12 weeks. There was a significant improvement in post operative BCVA at 4 weeks, from -1.42 to -0.33 LogMAR ( p=0.046), mean pre-operation target spherical equivalence (SE) was -1.53 diopter as the mean post-operation SE was -0.85 diopters. The mean operation time was 58.6 ±18.2 minutes. 33% of the patients had post operative complication with intra-ocular pressure spike was the most common complication (80%).

Conclusions:

The 4 flanged lasso technique is a safe, reproducible scleral fixation method, with a quick learning curve, for management of secondary IOL subluxation. We recommend considering this technique when approaching IOL subluxation patient as in many cases it obviates the need for complicated scleral suturing techniques.

Financial Disclosure:

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