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Arie Marcovich MD - PowerPoint PPT Presentation


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Technique for Scleral Fixation of Traumatic Subluxation of IOL. Arie Marcovich MD . Cornea Service, Kaplan Medical Center, Rehovot. No Financial Interest . To present a technique for repositioning of subluxated IOL to the anterior chamber after blunt trauma. Purpose:.

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slide1

Technique for Scleral Fixation of Traumatic Subluxation of IOL

Arie Marcovich MD

Cornea Service, Kaplan Medical Center, Rehovot

No Financial Interest

slide3

A 73 year-old woman was struck by tennis ball in OS

The IOL subluxated to the anterior chamber

On examination:

  • BCVA 20/200
  • IOP 16 mmHg
  • Fundus - Normal

IOL type: Hydrophilic acrylic B-lens (Hanita, Israel)

slide4

Two opposing paracenteses are performed

  • Sodium hyaluronate 1% is injected to the anterior

chamber

slide5
Double arm polypropylene 10-0 suture on straight needles passed above and below the subluxated haptic to opposite paracentesis

Suture used: Prolene® 10-0 Ethicon STC – 6, Johnson & Johnson, Belgium

slide6

The upper needle is inserted back below haptic

and drawn out through opposite paracentesis

slide7

The needle is reinserted above haptic and drawn

out through opposite paracentesis

forming a loop around haptic

slide9

The needles are guided out through the sclera

with a 27 gauge needle

  • Scleral fixation is performed under a flap
slide10
BCVA 20/40 Ref: - / -1.5 x 160

IOP 13 mmHg

IOL centered

One month postoperatively OS

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This technique enables to fixate the haptic of a hydrophilic acrylic IOL through corneal paracenteses

Scleral fixation is achieved under a flap

Anterior subluxation of IOL can be managed easily and atraumatically

Conclusions: