The “Suspension Suture” - A Novel Technique For Intraocular Lens (Iol) Fixation Using Polytetrafluoroethylene (Ptfe) Sutures

To evaluate the feasibility and early outcomes of a novel single continuous PTFE suture technique for 4-point scleral fixation in patients with dislocated intraocular lenses (IOLs). This technique aims to enhance lens stability, reduce surgical complexity, and improve postoperative visual outcomes compared to traditional multiple-suture methods.

This study was conducted at the Ophthalmology Department of Hadassah Medical Center, a tertiary care facility with expertise in complex vitreoretinal and anterior segment surgeries.

Fifteen patients (ages 63–82) with dislocated IOLs due to pseudoexfoliation syndrome and prior vitreoretinal procedures underwent IOL removal or exchange, followed by 4-point scleral fixation using a single continuous 6/0 PTFE suture. The technique involves a single uninterrupted suture to ensure even tension distribution across all four haptics, preventing IOL tilt or folding. The IOLs were centered along the axis between two pairs of sclerotomies placed 7 mm apart, promoting self-centration and long-term fixation stability.

At one-month follow-up, all IOLs remained well-centered, with no significant intraoperative or postoperative complications. Twelve patients demonstrated notable improvements in best corrected visual acuity (BCVA), progressing from counting fingers or hand motion to 0.1–0.32, while five patients maintained stable vision without further decline.

The single continuous PTFE suture technique for 4-point scleral fixation provides a simplified, efficient, and effective alternative to conventional IOL fixation methods. By ensuring stable lens centration, reducing surgical complexity, and minimizing complications, this approach has the potential to significantly improve outcomes in complex cases of IOL dislocation.