Purpose:

Describe a new sutureless technique for fixating the capsular bag in patients with zonular dialysis greater than 120º undergoing cataract surgery. The technique uses a 5.0 polypropylene suture and a Capsular Tension Segment to fixate the subluxated capsular bag in the sclera using a flanged method in the both side of the polypropylene.

Methods:

This study is a consecutive case series that evaluated seven eyes of seven patients with zonular dialysis greater than 120º undergoing cataract surgery. In all patients, after the phacoemulsification, the Double Flanged for Capsular Tension Segment Technique was performed. This procedure uses a sclerotomy 2.0 mm from the limbus in the same quadrant of the zonular weakness with a 30-gauge needle. It is used as an external guide of the 5.0 polypropylene suture within the sclera. The both sides of the suture are heated and shaped into a flanged. One side is inserted into the sclera and the other side is inserted in the suturing eyelet of the CTS.

Results:

We performed the described technique in seven patients and it was possible to conclude properly the procedure in six eyes. In one of patients, the flanged became thin, which made it impossible to reach the scleral stability intraoperatively. The other 6 eyes did not presented intra or postoperative complications, and besides, during a 6 months follow up it was not detected any intraocular lens dislocation.

Conclusions:

The absence of sutures, flaps and glue makes it faster to perform, induces less trauma and presents a less steep learning curve. It also avoids complications associated with suture degradation and subsequent IOL dislocation over time. However, as a new technique, it is necessary further studies with more patients and longer follow-up.