Re-fixation Using the Belt Loop Technique for Postoperative Subluxation of a Multifocal Intraocular Lens After Retinal Detachment Surgery: A Case Report

Intraocular lenses (IOLs) have evolved significantly with the development of cataract surgery. Today multifocal intraocular lenses (MFIOLs) are increasingly used due to their ability to reduce dependence on glasses and improve patient satisfaction. However, late complications, such as IOL dislocation, pose challenges, especially for patients wishing to retain MFIOLs. The belt loop technique (BLT), a sutureless scleral fixation method, has been proposed as a simple and minimally invasive solution for IOL repositioning. Despite its potential, clinical evidence supporting BLT, particularly its needle externalization approach, remains limited. This report describes a 64-year-old male with MFIOL dislocation. Following a history of macular-off rhegmatogenous retinal detachment (RRD) repair by vitrectomy with gas tamponade, the patient experienced vision decline due to IOL displacement. Using the BLT needle externalization approach, both haptics of the MFIOL were successfully repositioned. Postoperatively, the patient achieved stable and improved near and distance visual acuity without significant glare or halos, maintaining these outcomes over a half year. This case demonstrates the clinical efficacy of the BLT needle externalization approach for MFIOL repositioning. The technique offers a minimally invasive, effective alternative for managing dislocated IOLs, even in complex cases involving MFIOLs. This method holds promise as a valuable addition to the repertoire of IOL fixation techniques, while the long-term stability requires further study.