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

Or Shmueli,1,* Nir Erdinest,1,* Salome Goldmann,2 Yossi Eshel,1 Aseel Gebara,1 Ori Saban,1 Samer Khateb,1 Edward Averbukh,1 Itay Lavy1 1Department of Ophthalmology, Hadassah Medical Center, Faculty of Medicine, Hebrew University, Jerusalem, Israel; 2Faculty of Medicine, Hebrew University, Jerusalem, Israel*These authors contributed equally to this workCorrespondence: Or Shmueli, Department of Ophthalmology, Hadassah Medical Center, Faculty of Medicine, Hebrew University, Jerusalem, Israel, Tel +972-2-6778641, Fax +972-2-6776324, Email [email protected]: 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.Plain Language Summary: • Recently, a novel triangular suture technique has been introduced for the scleral fixation of dislocated intraocular lenses (IOLs).• This method involves creating a distinctive triangular suture support positioned posterior to the IOL.• The primary objective of this study was to evaluate the efficacy and safety of this new IOL fixation approach.• We followed 52 eyes of 49 patients for an average of 17 months, reporting good visual outcomes and a positive safety profile.• The novel triangular suture scleral IOL fixation offers good efficacy and safety, warranting further investigation to determine its broader applicability.Keywords: scleral fixation, triangular suture, intra-ocular lens, IOL, dislocation