title: Prevention of suture knot exposure in posterior chamber intraocular lens implantation by 4-point scleral fixation technique.
abstract: OBJECTIVE
  The results and complications of posterior chamber intraocular lens (IOL) implantation by a 4-point scleral fixation technique are described.
  
  
  METHODS
  Fifty eyes of 47 patients who underwent scleral-fixated IOL implantation were retrospectively evaluated. Twenty-one (42%) eyes had a history of trauma and 29 (58%) eyes had previously undergone cataract surgery. In all cases, IOL implantation by 4-point scleral fixation was performed and the knots of fixation sutures were rotated and buried in the globe. The IOL position was adjusted by suture rotation for best centration.
  
  
  RESULTS
  The mean follow-up time was 7 +/- 4 months. Four (8%) eyes had minimal corneal edema preoperatively. Cystoid macular edema was noted in 2 (6.8%) eyes in the cataract surgery group and 8 (38%) eyes in the posttraumatic group. Two (9.5%) eyes in the posttraumatic group had atrophic macular changes and 1 (4.7%) had corneal scarring, which impaired vision. No complications such as knot exposure, tilting of the IOL, decentralization, or endophthalmitis were noted postoperatively. Postoperative mean corrected visual acuity was 0.4 +/- 0.3 in the posttraumatic group and 0.4 +/- 0.2 in the cataract surgery group.
  
  
  CONCLUSIONS
  The 4-point scleral fixation technique resulted in no serious postoperative complications such as suture exposure and endophthalmitis. Because the knot can be rotated and buried in the globe, knot exposure is less likely to occur. This procedure is more effective than other techniques regarding IOL centralization.
authors.affiliation: Department of Ophthalmology Uludag University School of Medicine, Bursa, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Baykara
authors.forename: Remzi
authors.initials: R
authors.lastname: Avci
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction; D005131:Eye Injuries / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D012590:Sclera / Q000601:surgery*; D013536:Suture Techniques / Q000009:adverse effects; D016896:Treatment Outcome