A novel transscleral polypropylene loop rescue technique for preservation of a Carlevale intraocular lens after anchor plug rupture

PURPOSE: To describe a novel rescue technique for management of intraoperative rupture of a Carlevale FIL SSF IOL anchor-shaped plug using transscleral 10-0 polypropylene loop fixation. METHODS: A 72-year-old woman underwent pars plana vitrectomy and secondary implantation of a Carlevale FIL SSF intraocular lens following complicated cataract surgery associated with posterior capsular rupture and retained lens fragments. During externalization of the second anchor plug, intraoperative rupture of the nasal anchor-shaped haptic plug occurred, resulting in posterior displacement of the unsupported haptic segment into the vitreous cavity. To avoid intraocular lens explantation and additional corneal trauma in an already compromised eye, a rescue transscleral fixation technique using a double-armed 10-0 polypropylene loop surrounding the residual haptic segment was performed. RESULTS: The intraocular lens remained well centered and stable throughout the 12-month follow-up period without clinically appreciable tilt or decentration. Best-corrected visual acuity improved from 20/50 preoperatively to 20/30 at 3 months and remained stable thereafter. No cystoid macular edema, retinal complications, conjunctival erosion, suture exposure, or intraocular lens redislocation were observed. Intraocular pressure remained stable during follow-up. CONCLUSION: Transscleral 10-0 polypropylene loop fixation may represent a simple and effective rescue option in selected cases of Carlevale FIL SSF intraocular lens anchor plug rupture, allowing preservation of the original intraocular lens while avoiding explantation and additional corneal manipulation.