title: Comparison of ciliary sulcus fixation techniques for posterior chamber intraocular lenses.
abstract: OBJECTIVE
  To anatomically and histologically evaluate suturing techniques for sulcus fixation of posterior chamber intraocular lenses.
  
  
  METHODS
  Kitano Hospital, Osaka, Japan.
  
  
  METHODS
  The reproducibility of three suturing techniques (perpendicular to the eye wall; parallel to the iris; midway between perpendicular to the eye wall and parallel to the iris) were evaluated in a postmortem eye. Histologic sections of another eye and ultrasound biomicroscopy (UBM) images of 21 normal eyes were evaluated to determine the safety zone for the needle to avoid damaging adjacent structures.
  
  
  RESULTS
  The ciliary sulcus was completely penetrated in the three techniques in 100, 40, and 70% of cases, respectively. The histologic sections and the UBM images showed that when sutures were placed perpendicular to the eye wall, there was the possibility of postoperative angle closure and suturing parallel to the iris might damage adjacent structures because of a narrow safety zone.
  
  
  CONCLUSIONS
  The needle should penetrate obliquely, as in the technique in which the suturing is midway between perpendicular to the eye wall and parallel to the iris. This technique provides better reproducibility and causes less damage to adjacent tissue.
authors.affiliation: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Yasukawa
authors.forename: K
authors.initials: K
authors.lastname: Suga
authors.forename: J
authors.initials: J
authors.lastname: Akita
authors.forename: N
authors.initials: N
authors.lastname: Okamoto
mesh_terms: D002924:Ciliary Body / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D015812:Glaucoma, Angle-Closure / Q000517:prevention & control; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D007910:Lenses, Intraocular; D011183:Postoperative Complications / Q000517:prevention & control; D015203:Reproducibility of Results; D013536:Suture Techniques; D014463:Ultrasonography