ESCRS - PO355 - Rebite Technique: Sutureless Scleral Fixation Of A Dislocated One-Piece Iol – Easy, Fast, And Safe

Rebite Technique: Sutureless Scleral Fixation Of A Dislocated One-Piece Iol – Easy, Fast, And Safe

Published 2025 - 43rd Congress of the ESCRS

Reference: PO355 | Type: Free paper | DOI: 10.82333/zyrr-vc53

Authors: Nicholas Setter* ¹ , Gabriel Pipolo ¹ , Crislaine Serpe ¹ , Renata Trinkel ¹ , Henrique Possebom ¹ , Glauco Reggiani Mello ¹

¹Federal University of Parana,Curitiba,Brazil

Purpose

Describe a sutureless scleral fixation technique for an intraocular lens (IOL) without the need for lens exchange, combining principles from the Yamane double-needle, Canabrava 4-flanged, and Menna Barreto ViscoNeedling techniques. This approach is designed for anterior segment surgeons.

Setting

The study was conducted at the Menna Barreto Clinic (C.M.M. Barreto, P.K.M. Barreto, R.K.M. Barreto, and V.M.M. Barreto) in Porto Alegre, Rio Grande do Sul, Brazil, and the Medical School of Universidade de Caxias do Sul (V.F.M. Barreto, F.L. Fanton) in Caxias do Sul, Rio Grande do Sul, Brazil. The case was treated between May 2024 and November 2024.

Methods

Two syringes of viscoelastic were prepared with 30G needles, each curved at 20°. A 4.5 cm segment of 6-0 Prolene was inserted into the first needle, while the second contained only viscoelastic. Two paracenteses allowed viscoelastic injection, forceps access, and vitrectomy. A scleral puncture 2.5 mm from the limbus transfixed the capsule between the haptic and optic zone, injecting Prolene into the anterior chamber (ViscoNeedling). A second needle punctured the sclera 2.0 mm from the limbus, superior to the lens haptic. The suture was guided into the second needle’s lumen (Yamane), externalizing both ends. Finally, the Prolene ends were thermally modified (Rebite) for lens centralization and anchoring.

Results

The described case demonstrated excellent outcomes, with the lens well-centered and visual acuity stabilized at 20/20. A transient increase in intraocular pressure was observed in the immediate postoperative period, which was successfully controlled with topical medication. After six months, the IOL remained stable, with no complications or exposure of the rebite, which remained buried under the conjunctiva. The patient reported no foreign body sensation and remained asymptomatic. The Rebite technique proved to be an effective solution, leading to the successful resolution of the condition, improved visual acuity, and sustained intraocular lens stability throughout the follow-up period.

Conclusions

The Rebite technique is a fast, safe, and minimally invasive approach that operates within a closed system, eliminating the need for additional devices such as anterior chamber maintainers. The use of 6-0 polypropylene suture enhances long-term durability, overcoming the limitations of 10-0 sutures. This technique preserves the original intraocular lens, avoiding the need for lens replacement. By combining closed-system approaches, it increases accessibility for anterior segment surgeons, providing a versatile, efficient, and safe solution for managing ocular complications.