A New Iol Handling Device For Universal Iol Double Flanged Scleral Fixation
Published 2024 - 42nd Congress of the ESCRS
Reference: PP12.01 | Type: Free paper | DOI: 10.82333/1375-kx35
Authors: Miltiadis Tsilimbaris* 1 , Ioannis Stavgiannoudakis 1 , Aikaterini Seliniotaki 1 , Anastasia Papachristou 1 , Anastasios Stavrakakis 1
1University of Crete Medical School,Heraklion,Greece
Purpose
Accuracy in the symmetry of the suture passing points in the IOL' s optic, represents one of the challanges in the double-flanged IOL scleral fixation technique. The purpose of our work is to describe and present a novel instrument that permits an easy handling of any IOL during the precise pass of the suspending sutures for double flanged scleral fixation respecting the optic's diameter and the symmetry of the lens' suspending points.
Setting
The device was designed using CAD software and printed using a 3-D printer. It was sterilized in plasma and was used to hold and manipulate the IOL extraocularly.
Methods
The design includes 3 parts: 1) a handle that permits single-hand holding of the device and carries the sitting base of an IOL insert and a fixation lever, 2) an engraved, interchangeable IOL insert that permits the positioning of the desired IOL in the appropriate alignment assuring that the passing points of the suspending sutures will be symmetrically positioned at the IOL's optic; and 3) a lever that fixes the IOL in the desired position permitting the use of one hand for holding the instrument-IOL complex while the other is used to precisely pass the sutures through the pre-specified points of the IOL's optic. The device was used for suture placement in the IOLs prior to intraocular implantation.
Results
We present our experience from the use of the device in 20 patients using 3 different IOLs: B&L Envista, Alcon Acysoft and Zeiss Lucia. The design of the engraved insert permits an accurate alignment of the different IOLs so that the two slots expose two areas ideally positioned to offer axial symmetry of the suture passing points. Fixation of the IOL in position using the lever offers freedom to handle the device with one hand. The design of the lever and the insert offer adequate support while the suture needle is advanced through the lens' optic. The combination of the accurate symmetry of the sutures' position in the lens' optic with a corresponding axial symmetry is expected to minimize IOL tilting and subsequent induced aberrations.
Conclusions
We present a novel device that facilitates the precise symmetrical positioning of suspending sutures for double-flanged IOL scleral fixation. The appropriate design of IOL insert engravement makes the device suitable for any lens type. Axial symmetry of passing points and respect of the lens' optic diameter could result in minimal IOL tilting.