https://doi.org/10.31288/oftalmolzh201755659

The method of four-point fixation of the intraocular lens in the absence of capsular support (preliminary study)

I.Ya. Novytskyy, Dr Sc (Med), Prof.

Oculus Ophthalmic Clinic

Lviv (Ukraine)

E-mail: Inovytskyy@gmail.com

Introduction. Fixation of an intraocular lens (IOL) in the absence of capsular support is still a challenge for ophthalmic surgeons.

Purpose. To develop a technique of four-point IOL fixation in the absence of capsular support and to study its effectiveness.

Material and methods. We developed a new technique of four-point fixation of the IOL for the cases of capsular bag loss and used this technique in 5 consecutive cases. An IOL with four loops was inserted into the chamber anterior under viscoelastic protection.  A straight needle attached to a 10–0 polypropylene suture was introduced through the sclera 1.8 mm posterior to the limbus at 8 o'clock and was passed through the first and second loops and then was withdrawn from the opposite side 1.8 mm posterior to the limbus. Then needle was passed through the sclera and the same procedure was repeated for the third and fourth loops. The needle was passed through the sclera to the first point and the polypropylene sutures were gently pulled and tied.

Results: Postoperative period was without complication. The IOLs in all cases were stable with proper centration. The postoperative best-corrected visual acuity ranged from 0.3 to 0.9 depending on secondary pathology.

Conclusion. The technique of four-point fixation of the posterior chamber IOL is effective in cases of capsular bag loss. This technique provides good IOL fixation without creating a corneal wound or a scleral flap.

Key-words: absence of capsular bag, four-point fixation of the intraocular lens    

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