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 The authors have no financial interest in the subject matter of this e-poster.

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 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 1. Preparation for IOL setting of PC-9 hooking 10-0 double polypropylene thread (PC-9, Alcon) was inserted through the cartridge (E1, HOYA). PC-9 was looped around the haptics of the IOL (VA70AD or VA65BB, HOYA) by using a cow hitch knot.

5. Surgical Technique 2.Scleral pockets created at the 2 and 8-o’clock positions 3.Anterior vitrectomy performed 4.2.4-mm scleral corneal incision created at 12-o’clock position

6. 5.IOL setting: IOL and hooked PC-9 loaded into cartridge

7. 6.IOL inserted through incision with injector (ISH-001, HOYA), leaving opposite haptics out of anterior chamber 7.PC-9 looped around haptics 8.IOL fixed to ciliary sulcus

8. BCVA Surgically induced astigmatism was minimal Early improvement in BCVA maintained for 1 year SIA Result 1

10. Result 2 Mean endothelial cell density reduced 9.80% Complications – IOL iris capture and pupillary block in 1 case – Retinal detachment in 1 case – Cystoid macular edema in 1 case.

11. Treatments for Complications IOL capture – IOL repositioned – Peripheral iridectomy at 6 and 12 o’clock Retinal detachment – Scleral buckling surgery – Retina reattached Cystoid macular edema – Improvement without medication

12. Conclusion With this technique, visual acuity improved early postoperatively and was maintained for 1 year

13. 5.IOL setting: IOL and hooked PC-9 loaded into cartridge 6.IOL inserted through incision with injector (ISH-001, HOYA), leaving opposite haptics out of anterior chamber 7.PC-9 looped around haptics 8.IOL fixed to ciliary sulcus