Scleral Fixation of Akreos AO60 Intraocular Lens Using Gore-Tex Suture: An Eye on Visual Outcomes and Postoperative Complications

Figure 1

Illustration of basic surgical steps. The procedure begins with a standard 25-gauge three-port PPV. Here an inferior chandelier was also used (a). A Mendez ring is used to mark the horizontal axis to assure adequate sclerotomy positioning and lens centration (b), and nasal and temporal limited conjunctival peritomies are created (c). Calipers are used to mark the sclerotomy sites 2.5 mm behind the limbus and 5 mm apart (d), and four distinct sclerotomies (two nasal and two temporal) are made using the 25-gauge empty trocar needle (e). A 3.2 mm clear corneal incision is then made (f). The Gore-Tex suture is cut in half, the needle is removed, and the suture is then looped through the eyelets of the IOL (g). Each end of the suture is then transferred to the anterior chamber externalized through the corresponding sclerotomy, using non-serrated vitrectomy forceps (h). The Akreos IOL is easily folded and fits through the 3.2 mm corneal incision (i, j). The knots are tied with a 3-1-1 technique and rotated into the sclerotomy (k). Conjunctival peritomies are carefully closed with 7–0 vicryl. The corneal incision is usually self-sealing. Here a 10–0 monofilament suture was required (l).

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