1. Technique for Scleral Fixation of Traumatic Subluxation of IOL
Arie Marcovich MD
Cornea Service, Kaplan Medical Center, Rehovot
No Financial Interest

2. Purpose:
To present a technique for repositioning of subluxated IOL to the anterior chamber after blunt trauma

3. 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)

4. Two opposing paracenteses are performed
Sodium hyaluronate 1% is injected to the anterior
chamber

5. 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

6. The upper needle is inserted back below haptic
and drawn out through opposite paracentesis

7. The needle is reinserted above haptic and drawn
out through opposite paracentesis
forming a loop around haptic

8. The haptic and optic are pushed below iris with
a Sinskey hook

9. The needles are guided out through the sclera
with a 27 gauge needle
Scleral fixation is performed under a flap

10. One month postoperatively OS
BCVA 20/40 Ref: - / -1.5 x 160
IOP 13 mmHg
IOL centered

11. Conclusions:
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