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Cow hitch suture technique (CHST) for repositioning and refixating dislocated late in-the-bag IOL complex

Poster Details

First Author: F.González del Valle SPAIN

Co Author(s):    A. Núñez Sánchez   J. Celis Sánchez   J. Zarco Tejada   R. Núñez Plascencia   E. López Mondéjar   R. Lorente Moore

Abstract Details


Propose a new surgical technique for the management of the late in-the bag intraocular lens (IOL) complex.


Ophthalmology Service. La Mancha-Centro Hospital. Alcázar de San Juan. CR, Spain


Prospective study (21,1 average months of follow up) of 9 patients (65,2 average age, 8 males/1 female) who previously undergone cataract surgery (7,8 years on average) with late in-the bag IOL luxation. Preoperative mean visual acuity was 0,26. In all cases this microsurgical approach (CHST) was used in combination with 25 or 23G 25-g vitrectomy system. The CHST consists in grasping and binding both haptics of the IOL (single or three pieces IOLs) with a 10-0 polypropilene suture, with the help of two disposable 25 or 23-g vitreoretinal microforceps, and suturing beneath a deep scleral flap to avoid photosuturolysis.


Repositioning of the in-the bag IOL complex in its anatomical site was achieved. Mean postoperative visual acuity improved to 0,53. No luxation recurrence was reported at last follow up.


This new surgical approach could be a good option for improving visual and anatomical results for late in-the-bag IOL dislocation. Using a simple intraocular cow hitch knot, all of the objectives could be achieved: managing the bag-IOL complex, repositioning of the dislocated IOL, and preserving the capsular bag and the ocular anatomical compartmentalization. FINANCIAL INTEREST: NONE

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