Purpose: We present a modified technique in performing scleral fixation of a posterior chamber intraocular lens (IOL) using 2 pairs of double-armed 9-O polypropylene sutures and an ab-externo technique, in 2 patients with surgical aphakia after complicated cataract surgery.
Methods: Two eyes of 2 patients underwent this modified technique by an experienced cataract surgeon (A.L.Y.) in 2022. We evaluated pre- and postoperative best-corrected visual acuity, perioperative complications, corneal endothelial cell density by specular microscopy, and IOL position by anterior segment optical coherence tomography and ultrasound biomicroscopy.
Results: Both patients achieved an improvement in best-corrected visual acuity from 20/50 to 20/30 and 20/80 to 20/50, respectively. There was a loss in endothelial cell count in both cases (8% and 23%, respectively). No complications were noted in both cases, and postoperative anterior segment optical coherence tomography and ultrasound biomicroscopy showed a stable scleral fixation of IOL at more than 20 months postoperatively.
Conclusions: The utilization of 2 pairs of double-armed 9-O Prolene suture may provide a stronger alternative than conventional scleral fixation of IOL with single suture.
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