Scleral Fixation Technique With 6/0 Prolene® And 30G Ultra-Thin Wall Needle.

To analyze the results of an intrascleral fixation technique using 6/0 prolene® endings and a 30G ultra-thin wall needle.

 

Universitary hospital complex A Coruña 

Retrospective case series of patients that underwent this technique for repositioning the intraocular lens sac-entity complex (IOL) or fixation of a capsular tension segment (CTS) in subluxated lens surgery. Fixation is based on introducing the prolene suture, in the case of repositioning through the sac-IOL complex or in the case of lens surgery subluxed by the CTS hook whose end of the suture we have previously cauterized outside the eye. Subsequently, the prolene® is exteriorized through the sclera 2 mm from the limbus using the previously inserted 30G needle and then some endings are created by cauterizing the last part of the prolene flanges that are inserted at the entrance of the scleral tunnel to ensure optimum hold.

 

33 eyes were studied with a mean follow-up of 6.8±5.9 months. The patients mean age was 76.8±14.2 years and the indications were subluxation of the IOL-sac complex in 23 cases and subluxation of the cataract in 10 cases. Preoperative mean corrected visual acuity was 0.8±0.7 LogMAR and postoperative was 0.3±0.4 LogMAR. Mean preoperative intraocular pressure (IOP) was 18.7±6.2 mmHg and postoperative was 16.1±4.0 mmHg. Complications were ocular hypertension in 10 cases, 3 self-limiting scleritis around flanges, 3 mild IOL decentering, 2 pseudophakic macular edema, 2 vitreorrhagia cases, 2 cases of subtenon prolene flanges. A second surgery (trabeculectomy or IOL replacement) was necessary in 5 patients, 3 of them with high IOP previously. 

Scleral fixation with 6/0 prolene® and a 30G ultra-thin wall needle is a simple, minimally invasive and safe technique.