Rectangular loop suture to correct iris capture of the posterior chamber intraocular lens
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Rectangular loop suture to correct iris capture of the posterior chamber intraocular lens Ke Lin, Zhixiang Hu, Zhong Lin, Tianyu Chen, Yongping Tang and Ronghan Wu*
Abstract Background: To report a new technique for iris capture of the posterior chamber intraocular lens (IOL) implanted in patients with a posterior capsule defect. Methods: In this retrospective case series, a rectangular loop ciliary body suture technique was performed to rectify iris capture. The suture passes between the IOL and iris in a direction perpendicular to the iris edge capturing the IOL. Results: A total of three IOLs with iris capture underwent a rectangular loop suture technique. No recapture was observed postoperatively. In one case, large astigmatism appeared after the surgery but recovered at 1 month post operation. No further complications were found. Conclusions: The rectangular loop suture technique is an effective, convenient, and minimally invasive method for iris capture of the IOL. Keywords: Iris capture, Posterior chamber intraocular lens, Rectangular loop suture
Background In eyes with a capsular defect, intracapsular intraocular lens (IOL) implantation is not possible. Accordingly, several alternative surgical techniques can be applied, including transscleral IOL fixation, sutureless intrascleral fixation, and the scleral hook technique [1–3]. While these have proven to be safe and effective, some complications remain, including suture breakage, IOL tilt or dislocation, haptic slip, and iris capture [4–6]. Cho and Yu reported an incidence of iris capture of 23% in patients who underwent combined scleral IOL fixation and pars plana vitrectomy. Iris capture leads to blurred vision, photophobia, and dull pain. Moreover, iritis and secondary glaucoma may occur during long-term iris capture [7].
Iris capture of the IOL may be caused by pupil dilation [8], IOL deviation or tilt, a floppy iris [9], or reverse pupillary block [10]. Although pupil dilation or laser iridotomy of a reverse pupillary block are useful for iris capture, their success rates are relatively low [11–13]. When iris capture is not resolved by these techniques, surgical techniques can be applied, including IOL repositioning [12] and exchange [14]. However, these surgeries cause relatively large injuries and can result in bleeding and corneal endothelium loss. We performed a minimally invasive technique for three cases, and no iris recapture was observed post surgery.
Methods Surgical technique
* Correspondence: [email protected] Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou 325000, Zhejiang Province, China
First, we design the route of sutures according to the appearance of patient’s anterior segment. The sutures are perpendicular to the iris edge capturing the IOL preoperatively. For example, the direction of sutures in Fig. 1
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which perm
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