Secondary Posterior Chamber Intraocular Lens Fixation Using Flanged Prolene Sutures as an Alternative to an Anterior Chamber Intraocular Lens Implantation

Figures & data

Figure 1 Key steps in the Flanged Prolene Suture intraocular lens (IOL) fixation (PIF) technique: (A) Removal IOL through large incision. (B) Docking 5–0 prolene through 27-gauge TSK needle one side. (C) Docking prolene other side. (D) Place prolene through Islet of CZBD IOL. (E) Create flange with cautery. (F) Insert IOL. (G) Cut long end of prolene ~2mm from tip. (H) Create flange with cautery and tuck into scleral opening. (I) IOL well centered, closure of scleral (or corneal) wound.

Table 1 Clinical Characteristics of Patients That Had ACIOL Implantation and PIF

Clinical Characteristics	ACIOL (±SD)	PIF (±SD)	P value
Age	81.4 (9.8)	86.1 (7.2)	0.216
Visual acuity at presentation (LogMAR)	1.17 (0.651)	1.42 (0.66)	0.354
Visual acuity at baseline (LogMAR)	0.54 (0.27, n=10)	0.90 (0.68, n=7)	0.14
Follow-up time (days)	131.42 (54)	117.8 (23.18)	0.48
Indication for surgery	n (%)	n (%)
Dislocated 1-piece IOL in the bag	8 (57)	6 (60)
Dislocated PMMA IOL in the bag	2 (14.3)	1 (10)
Dislocated 3P-IOL after FIF	0	1 (10)
ACIOL	0	1 (10)
Mature lens	0	1 (10)
Aphakia	3 (21.4)	0
UGU syndrome	1 (7.1)	0

Note: P value <0.05 was considered statistically significant.

Abbreviations: ACIOL, anterior chamber IOL; PIF, four-point intraocular lens (IOL) fixation; PMMA, poly(methyl methacrylate); FIF, Fixation with Double-Needle Technique; UGU, uveitic hyphema glaucoma syndrome.

Table 2 Change in Visual Acuity results from Presentation to the Last Follow-Up

Patients (n)	Visual Acuity at Presentation (±SD)	Visual Acuity at the Final Follow-Up (±SD)	P value
All patients (24)	1.27 (0.65)	0.84 (0.65)	<0.0001
ACIOL patients (14)	1.17 (0.64)	0.82 (0.64)	<0.001
PIF patients (10)	1.42 (0.66)	0.88 (0.53)	<0.001

Note: P value <0.05 was considered statistically significant.

Abbreviations: ACIOL, anterior chamber IOL; PIF, four-point intraocular lens (IOL) fixation.

Table 3 Change in Visual Acuity Results from Baseline to the Last Follow-Up

Patients (n)	Visual Acuity Before IOL Dislocation (±SD)	Visual Acuity at the Final Follow-Up (±SD)	P value
All patients (17)	0.69 (0.5)	0.90 (0.61)	0.094
ACIOL patients (10)	0.54 (0.27)	0.85 (0.65)	0.145
PIF patients	0.90 (0.68)	0.97 (0.61)	0.334

Note: P value <0.05 was considered statistically significant.

Abbreviations: ACIOL, anterior chamber IOL; PIF, four-point intraocular lens (IOL) fixation.

Table 4 Intraoperative and Postoperative Complication

Complication	ACIOL (%)	PIF (%)
Intraoperative complications	0	0
IOP elevation	0	0
Hyphema	0	0
Vitreous hemorrhage	0	0
IOL tilt or decentralization	0	0
CME	1 (7.1)	2 (20)
Corneal edema	2 (14.3)	1 (10)

Abbreviations: ACIOL, anterior chamber IOL; PIF, four-point intraocular lens (IOL) fixation; IOP, intraocular pressure; CME, cystoid macular edema (CME).