A Novel Approach To Lens Subluxation: Capsulaser And Flanged Prolene Suture For Cionni Ring Scleral Fixation

evaluating an innovative surgical approach to lens subluxation using selective laser capsulotomy (SLC) and scleral fixation of Cionni rings using a flanged 6-0 polypropylene suture.

magrabi eye hospital. jeddah, ksa

. All surgeries were done by a single surgeon (AS)
using a novel technique with selective laser capsulotomy using CAPSULaser. the phacoemulsification was done after using iris hooks to stabilize the bag. Cionni ring was implanted and fixated to the scleral using 6/0 prolene flanged suture
Post-operative follow up records for all patients regarding IOL centration,
stability of the capsular bag, any reported signs of inflammation or high IOP
together with manifest refraction and BCVA and any adverse events related to
the treatment procedures.,

This study included six cases of pseudoexfoliation syndrome (PEX) with mean age was 58.2 ± 9.7 and nine cases of hereditary lens subluxation with mean age of 18.3±3.3 years. In the subluxation cases, the mean pre-operative sphere and cylinder were – 11.33±2.8D and 6.2±0.7D cylinder. This improved post-operatively to -1.5±0.4D and -2.25±0.9D respectively with mean pre-operative BCVA 20/200 compared to 20/25 post-operatively,  In PEX cases, the BCVA improved from 20/100 to 20/30 (p˂0.05). All cases ended with preservation of the capsular bag. The mean follow-up period was 5.6 ± 1.1 months.   All patients had an adequately centered IOL post-operatively. In no eye wasconjunctival erosion related to flanged suture detected.  

Selective laser capsulotomy using CAPSULaser hat it is a safe and effective tool for creating well centered, accurately sized and circular capsulotomies with consistent 360 degree IOL coverage. This ensures better lens stability and effective lens positioning inside the capsular bags in cases of lens subluxation. Combined with flanged 6-0 polypropylene sutures for scleral fixation of Cionni rings, this technique addresses previous limitations by improving intraoperative control, minimizes surgery time, reduces the risk of complications, and enhances outcomes.