1. Outcomes of Transscleral Sulcus Fixation of Intraocular Lenses through a 2.4-mm Incision with an Injector System: 1-Year Follow-Up
Akiko Masai, MD, Tomoichiro Ogawa, MD
Takuya Shiba, MD, Hiroshi Tsuneoka, MD
Department of Ophthalmology
The Jikei University School of Medicine
Tokyo, Japan
Ｎo financial interest

2. Objective
To evaluate postoperative outcomes of scleral-sutured ciliary sulcus fixation of foldable intraocular lens (IOL) through a 2.4-mm incision

3. Methods Subjects: 9 eyes (9 patients) Lens subluxation : 1 eye
Aphakia : 5 eyes
IOL dislocation : 3 eyes
⇒the lenses were divided in the eye
and extracted through 2.4mm incision.
Variables examined
Best-corrected visual acuity (BCVA)
Before and after surgery (1 week; 1, 3, 6, 12 months)
Surgically induced astigmatism (SIA) (Cravy method)
After surgery (1 week; 1, 3, 6, 12 months)
Endothelial cell density
Before and after surgery

4. Surgical Technique Preparation for IOL setting of PC-9 hooking
10-0 double polypropylene thread (PC-9, Alcon) inserted through cartridge (E1, HOYA)
PC-9 looped around haptics of IOL (VA70AD or VA65BB, HOYA) with cow-hitch knot
IOL
cartridge
PC9
cow hitch knot

5. Surgical Technique
Scleral pockets created at the 2 and 8-o’clock positions
Anterior vitrectomy performed
2.4-mm scleral corneal incision created at 12-o’clock position
IOL setting: IOL and hooked PC-9 loaded into cartridge
IOL inserted through incision with injector (ISH-001, HOYA), leaving opposite haptics out of the eye
PC-9 looped around haptics
IOL fixed to ciliary sulcus

6. Result 1
Early improvement in BCVA maintained for 1 year
BCVA
(LogMAR)

7. Result 2
Surgically induced astigmatism was minimal
SIA (D)

8. Endothelial cell density
Result ３
Mean endothelial cell density reduced 9.80%
Endothelial cell density
2053
1853
pre
post
(/mm2)
2000
1000

9. Conclusion Sulcus fixation of an IOL by the injector
reduced the number of intraocular actions because of the preoperative preparation for IOL setting of PC-9 hooking.
allowed IOL insertion through a small incision.
With this technique, visual acuity improved early postoperatively and was maintained for 1 year