Management of severe intraocular lens tilt using transsulcus retention sutures
Year: 2025
Type: article
Study design: Case Report
Abstract: In eyes lacking capsular support, scleral-fixated intraocular lens (SF IOL) implantation serves as an effective solution. However, unintended SF IOL tilt can adversely affect patient outcomes. Drawing inspiration from the use of retention sutures in other surgical settings, we introduce a novel technique that uses transsulcus retention sutures (TSRSs) to treat severe SF IOL tilt in the use of 3 patients. The index case presented with uveitis–glaucoma–hyphema syndrome after double-flanged scleral fixation, while 2 other patients suffered from malfunction of the haptic–optic junction during flanged haptic scleral fixation. Severe optic tilt was noted in all 3 patients. Paired TSRSs were made by passing 9-0 polypropylene to and from the opposite scleral wall 3 mm apart in the sulcus plane, centered over the IOL optic, to either segregate the IOL optic from the posterior iris or to sandwich the IOL between 2 pairs of TSRS. Resolution of severe tilt and their sequelae were achieved in all cases.
Authors: Deven Huang, Lorenzo J. Cervantes
Institution: New York University
Language: English
Subfield: Ophthalmology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,000
OpenAlex ID: W4409177801
