Modified Intraocular Lens Intrascleral Fixation Technique Using Two Vitrectomy Ports as Lens Haptic Fixation Sites

Yukihiko Suzuki, Toshio Tando, Kobu Adachi, Takashi Kudo, Mitsuru Nakazawa

Department of Ophthalmology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan

Correspondence: Yukihiko Suzuki Tel +81-172-39-5095
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Email yukihiko@hirosaki-u.ac.jp

Introduction: We developed a new technique that uses two of the vitrectomy ports as intraocular lens (IOL) haptic fixation sites and compared that with a conventional T-fixation method.
Methods: A total of 33 eyes were retrospectively divided into the port-fixation (n=21) and conventional (n=12) groups. For the port-fixation group, supranasal and inferotemporal trocars (25-gauge) were placed in the center of a T-shaped lamellar scleral incision 2 mm from the corneal limbus and a supratemporal trocar at 3.5 mm. Following a vitrectomy, along with lens or IOL extraction as needed, the infusion cannula was changed from an inferotemporal to supratemporal trocar. The first IOL haptic and trocar were then simultaneously withdrawn from the eye by grasping with vitreoretinal forceps, with the same performed for the second IOL haptic and trocar, after which the infusion cannula was removed. In the conventional group, 2 T-shaped scleral incisions and three trocars were separately placed.
Results: Postoperatively, transient ocular hypotension and hypertension were observed in a few eyes in both groups. At 6 months after surgery, astigmatism was 1.71± 1.13 D in the port-fixation group and 2.21± 1.78 D in the conventional group (p=0.40, t-test).
Conclusion: This new technique may be effective because of the lower number of scleral wounds.

Keywords: intraocular lens, intrascleral fixation, cataract surgery, lens subluxation, vitrectomy