Purpose:

To describe the use 8-0 polypropylene (Prolene) suture for 4-point fixation of a foldable acrylic posterior chamber (PC) intraocular lens (IOL).

Methods:

Four scleral spots are marked 4.0 mm apart and 2.5 mm from the limbus where sclerostomies are performed. A partial thickness scleral groove is created to form the bed for the sutures. Two sets of 8-0 Prolene sutures are passed through the 4 IOL haptics in an anterior to posterior route with the lens oriented on the cornea-scleral surface in the horizontal meridian. The IOL was entered into the anterior chamber behind the iris and sutures were pulled ab interior, thus no handshake technique. The IOL is then unfolded on its long axis and the sutures are tightened for optimal IOL centration. The exposed sutures are placed within the surgically created vertical scleral groove and fibrin glued.

Results:

The four-point sclera fixation technique was uneventful and easy to perform. The IOL was well centered postoperatively and has remained stable for the follow up period of 12 months.

Conclusions:

Four-point scleral fixation with 8-0 Prolene suture is a novel technique that can optimize the centration and stability of scleral fixation IOL without the use of handshake technique.