Evaluating the Efficacy of a Novel Triangle Suture Technique in Scleral-Fixation of Intraocular Lens

Purpose: The study aims to evaluate the efficacy and safety of a novel Triangle Suture Technique in the surgical placement of Scleral-Fixated Intraocular Lenses (SFIOLs). The research seeks to address the challenges in cases associated with inadequate capsular support for Intraocular Lens (IOL) implantation, offering an alternative to traditional methods. Methods: This A pilot retrospective case series evaluated the efficacy and safety of a novel Triangle Suture Technique for scleral-fixation of intraocular lenses (SFIOL) using 10-0 Polypropylene suture (Prolene; Ethicon, Inc) in patients with dislocated IOLs. Visual acuity outcomes, intraocular pressure control, and post-operative complications were assessed. Results: The study comprised 52 eyes from 49 patients (mean age 80.3±10.3 years). Mean pre-operative uncorrected visual acuity (UCVA) significantly improved from 1.14±0.84 to 0.61±0.56 logMAR at 3 months (P=0.001). Best-corrected visual acuity (BCVA) also improved from 0.84±0.65 to 0.54±0.56 logMAR at 3 months (P=0.048). Glaucoma drop usage decreased from 0.67±1.09 to 0.25±0.62 types at 6 months (P=0.018). Peri-operative complications included anterior segment complications in 4 eyes (7.54%) and posterior segment complications in 1 eye (1.9%). While non-recurrent IOL dislocation occurred in 45 eyes (86.5%), recurrent dislocation was noted in 7 eyes (13.5%), with one eye experiencing twice recurrent dislocation (1.9%). Conclusion: The triangle suture technique is a versatile and accessible option for scleral fixation of various IOL designs. While these preliminary results demonstrate anatomical efficacy, the study's retrospective nature, small cohort, and single-surgeon experience necessitate a cautious interpretation. Further large-scale, comparative studies are required to establish long-term stability and clinical efficacy relative to current gold-standard methods.