Sutureless Scleral Fixated IOL: The “Catcher Pole” Technique

Abstract

Purpose

To describe a new surgical technique for sutureless intrascleral intraocular lens (IOL) fixation with an adapted retinal scraper used as an instrument “the Catcher Pole” to retrieve the IOL haptic through a scleral tunnel.

Setting

Public Eye Hospital, Roma, Italy.

Design

Retrospective case series.

Methods

Twenty-one eyes from 19 patients who underwent sutureless intrascleral IOL fixation were studied. A standard three-piece posterior chamber IOL (PCIOL) was implanted in aphakia or rescued and fixated in cases of dislocated PCIOL. A 23 to 25 G retinal loop scraper (the “Catcher Pole“) was inserted through a 1.5 mm long tunneled sclerotomy performed on the horizontal meridian, to capture, hold and externalize the tip of the haptic of the IOL. A flange created with an handheld cautery on the externalized haptic tip prevents IOL slippage. The best-corrected visual acuity (BCVA), central corneal pachymetry (CCP), IOL tilt and complications were assessed.

Results

In twenty-one eyes of 19 patients, the mean preoperative BCVA was 0.61 logMAR units ±0.05 SD, and the mean postoperative BCVA improved significantly to 0.18 logMAR units at three months ±0.05 SD (P=0.002). The mean preoperative CCP was 610 µ ±17 SD and the mean postoperative CCP 623 µ ±16 SD, (P=0.73). In the subgroup that underwent IOL tilt evaluation, mean IOL tilt was 3.19±2.01. The postoperative complications included iris capture of the IOL in one eye (4,7%) and transient ocular hypertension in two eyes (9,4%).

Conclusions

The “Catcher Pole” sutureless intrascleral IOL fixation technique is easy to perform with reduced anterior chamber manipulations and achieves both anatomical and optical stability.

Graphical abstract

Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use:

https://youtu.be/jwiK7MtrVsU

Keywords:

• intrascleral intraocular lens fixation
• Catcher Pole technique
• capsular loss

Disclosure

The article has not been presented at any meeting. The authors did not receive any financial support from any public or private sources. The authors have no financial or proprietary interest in a product, method, or material described herein. The authors report no conflicts of interest in this work.