Belt-loop Scleral Fixation with Pars Plana Vitrectomy for Dislocated Trifocal Intraocular Lens with Double C-loop Haptics: A Case Series

Purpose: To evaluate the clinical outcomes of a modified belt-loop scleral fixation technique for repositioning dislocated trifocal intraocular lenses (IOLs) while preserving the original multifocal IOL.Methods: This retrospective case series included six eyes of five patients with subluxated or dislocated FineVision POD F trifocal IOLs.All eyes underwent pars plana vitrectomy (PPV) with complete capsular bag removal, followed by belt-loop scleral fixation using a 6-0 polypropylene suture and a 27-gauge needle docking technique.Visual acuity, refractive outcomes, corneal endothelial parameters, and postoperative complications were evaluated preoperatively and postoperatively.Results: Mean uncorrected visual acuity improved from 1.04 ± 0.60 to 0.057 ± 0.06 logMAR (p = 0.027).Corrected distance visual acuity improved from 0.14 ± 0.28 to 0.03 ± 0.06 logMAR.The mean postoperative spherical equivalent was -0.38 ± 0.49 diopters.At 3 months postoperatively, near visual acuity at 40 cm was J1 in four eyes (66.7%) and J2 in two eyes (33.3%).Corneal endothelial cell density showed no significant changes (2,743 ± 214 to 2,608 ± 174 cells/mm 2 , p = 0.207).No cases of IOL redislocation were observed.Minor complications included transient intraocular pressure elevation and hyphema, both of which resolved without sequelae.Conclusions: The modified belt-loop scleral fixation technique combined with PPV resulted in favorable visual and refractive outcomes without the need for IOL exchange.Removal of vitreous traction and capsular remnants may have contributed to the favorable postoperative visual outcomes we observed.This approach appears to be a safe and effective option for managing dislocated trifocal IOLs.