title: Modified technique for transscleral fixation of posterior chamber intraocular lenses.
abstract: BACKGROUND
  Suture exposure remains to be a potential problem of transscleral fixated posterior chamber intraocular lens (PCIOL). We report a modified technique to minimize the risk of suture exposure for the transscleral fixation of PCIOL.
  
  
  METHODS
  The modified surgical technique is as following: at first, two 3 mm × 4 mm square scleral pockets were created from groove incisions at opposite positions. A straight needle attached to a 10-0 polypropylene suture was passed through one incision groove. Then, a 27-Gauge hollow needle passed through the opposite sclera incision bed was used to retrieve the straight fine needle via its barrel. The sutures were tied to themselves after one more bite on the scleral bed. At last, the suture ends were left long (about 4 mm) and laid flat into corresponding laminar scleral pockets. This modified technique of PCIOL was performed in 48 post-traumatic aphakic vitrectomized eyes from 48 patients (47 male, one female) with mean age of 34.8 ± 14.8 years. Main outcome measures included best corrective visual acuity (BCVA), IOL decentration, IOL tilt, and postoperative complications.
  
  
  RESULTS
  The mean follow-up was 32.3 ± 10.8 months (3-67 months). The LogMAR BCVA remained stable, from a preoperative value of 0.46 ± 0.34 to postoperative 0.44 ± 0.34 (p = 0.69). Mild IOL tilt (5-10°) was observed in five eyes, and slight IOL decentration (0.5-1.0 mm) was seen in three cases. No case of suture exposure, suture breakage, IOL dislocation, or endophthalmitis was observed during the follow up period.
  
  
  CONCLUSIONS
  The modified technique allowed stable placement of PCIOLs in post-traumatic aphakic eyes with a wide range of follow-up. Our procedure might have the potential benefit to avoid suture exposure in scleral-fixated IOL implantation.
authors.affiliation: From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 South Xianlie Road, Guangzhou, 510060, Guangdong, China. zoclong@21cn.com.
authors.forename: Chongde
authors.initials: C
authors.lastname: Long
authors.affiliation: From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 South Xianlie Road, Guangzhou, 510060, Guangdong, China. weiyantao75@126.com.
authors.forename: Yantao
authors.initials: Y
authors.lastname: Wei
authors.affiliation: From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 South Xianlie Road, Guangzhou, 510060, Guangdong, China. jorphin@hotmail.com.
authors.forename: Zhaohui
authors.initials: Z
authors.lastname: Yuan
authors.affiliation: From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 South Xianlie Road, Guangzhou, 510060, Guangdong, China. zhang-zhiqing@sohu.com.
authors.forename: Zhiqing
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 South Xianlie Road, Guangzhou, 510060, Guangdong, China. linxiaof@mail.sysu.edu.cn.
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Lin
authors.affiliation: From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 South Xianlie Road, Guangzhou, 510060, Guangdong, China. bingqianliu@gmail.com.
authors.forename: Bingqian
authors.initials: B
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D001036:Aphakia, Postcataract / Q000601:surgery; D002648:Child; D005131:Eye Injuries / Q000601:surgery; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007908:Lens, Crystalline / Q000293:injuries; D008297:Male; D008875:Middle Aged; D011126:Polypropylenes; D011183:Postoperative Complications; D012590:Sclera / Q000601:surgery*; D013536:Suture Techniques; D013537:Sutures; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D055815:Young Adult
chemical_list: D011126:Polypropylenes