A New Approach Using an Artificial Suture Platform for Repositioning Dislocated Intraocular Lenses Regardless of IOL Type

PURPOSE: To evaluate the safety and effectiveness of a novel artificial suture platform technique for repositioning dislocated intraocular lenses (IOLs) across diverse IOL types and complex clinical scenarios. METHODS: This retrospective, interventional case series included 14 eyes of 13 patients (7 men, 6 women; mean age, 55.5 ± 19.5 years) with IOL dislocation treated between January 2023 and December 2024 at a tertiary referral center. The technique involved constructing an artificial suture platform beneath the sclera with transconjunctival 10-0 polypropylene sutures, forming two parallel square suture lines for a stable artificial sulcus. Four-point haptic fixation was performed regardless of IOL model or haptic integrity. Patients were followed for at least 6 months. Outcomes included changes in best-corrected visual acuity (BCVA, logMAR), intraocular pressure (IOP), refractive parameters, and postoperative complications. RESULTS: The original IOL was repositioned in 13 eyes (92.9%); one eye (7.1%) required IOL exchange. Mean follow-up was 9.1 ± 1.7 months. Mean BCVA improved from 1.70 ± 0.85 logMAR (≈20/1000 Snellen) to 0.37 ± 0.35 logMAR (≈20/50 Snellen), corresponding to an average gain of ≈10 ETDRS lines (≈50-55 letters) (mean difference, 1.33 logMAR; 95% CI, 0.89-1.77; p = 0.001). Postoperative IOP, spherical equivalent, and astigmatism did not significantly change (all p > 0.05). One case (7.1%) developed transient IOP elevation, resolving after YAG-laser iridotomy. No other complications occurred. CONCLUSIONS: The artificial suture platform technique demonstrates favorable short-term safety, versatility, and effectiveness for IOL repositioning, especially when conventional methods are unsuitable.