Pars plana suture fixation for intraocular lenses dislocated into the vitreous cavity using a closed-eye cow-hitch technique.
ABSTRACT We describe a modified intraocular cow-hitch technique for pars plana suture fixation of intraocular lenses (IOLs) that dislocated into the vitreous cavity in 3 patients who had a 3-port vitrectomy and IOL implantation because of retinal disease. To reposition the dislocated IOL after the residual vitreous was removed, 2 additional sclerotomies for suture fixation were made 3.0 mm posterior to the limbus. A loop (cow-hitch knot) was made with 10-0 polypropylene for suture fixation. After the neck of the cow-hitch loop was grasped with an intraocular forceps, the loop was used to lasso a haptic of the dislocated IOL, which was then pulled forward to the sclerotomy. The same procedure was used for the other haptic, and both sutures were secured to the sclera under scleral flaps. In all patients, the dislocated IOLs were repositioned without the need for extraction. The procedures were uneventful. Pars plana suture fixation with the intraocular cow-hitch technique can be used to reposition an IOL that has dislocated into the vitreous cavity.
Article: 'Ab interno' intravitreal suturing of a large traumatic scleral perforation at the posterior pole.The British journal of ophthalmology 01/2008; 91(12):1721-2. · 2.92 Impact Factor
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ABSTRACT: Scleral fixation of intraocular lenses (IOLs) can be performed under the protection of a scleral flap. A variation of this technique uses a scleral tunnel for suture fixation to the eye. Passage of a double-armed suture through the roof of the scleral tunnel with subsequent retrieval of the suture ends through the external incision for tying facilitates scleral fixation. This modification offers several advantages: A scleral tunnel is easier to construct than a triangular flap and does not require suture closure. It affords a greater surface area for suture placement through an ab externo or ab interno approach. Tying each suture allows the suture knot to pass under the roof of the tunnel, eliminating the need for suture knot rotation. Suture retrieval and scleral fixation through a scleral tunnel incision offers a simplified and elegant method for fixation of IOLs and other intraocular adjunctive devices.Journal of Cataract [?] Refractive Surgery 09/2006; 32(8):1259-63. · 2.26 Impact Factor
Article: Scleral Fixation of Dislocated Intraocular Lenses by Haptic Externalization through a Clear Corneal Incision.[show abstract] [hide abstract]
ABSTRACT: Several techniques have been employed for repositioning dislocated intraocular lenses (IOLs). Herein, we describe a simplified and modified technique in which scleral fixation is performed together with temporary externalization of IOL haptics through a small, superior clear corneal incision. The sutures are tied to the externalized haptics; the haptics are then repositioned into the anterior chamber followed by IOL reimplantation into the ciliary sulcus. Using this technique, the dislocated IOL is repositioned under direct visualization without need for IOL extraction or extensive intraocular manipulations.Journal of ophthalmic & vision research. 10/2009; 4(4):266-9.