6/0 PROLENE DOUBLE-FLANGED INTRAOCULAR LENS SUTURELESS SCLERAL FIXATION WITH A 27-GAUGE NEEDLE FOR INTRAOCULAR LENS SURGERY

Purpose: To report the initial experience of a modified intraocular lens (IOL) scleral fixation technique using 6/0 prolene in a double-flanged sutureless technique with a 27-gauge needle. Methods: Twenty-nine consecutive patients with IOL surgery were retrospectively reviewed between December 2021 and October 2023. Early Treatment Diabetic Retinopathy Study letters, spherical equivalent (SE), astigmatism axial degree, and intraocular pressure were evaluated at baseline and 1, 2, 3, and 6 months postoperatively. Surgery-related complications were evaluated during follow-up. Results: Early Treatment Diabetic Retinopathy Study letters or SE at 1, 2, 3, and 6 months postoperation was significantly improved compared with baseline levels. Patients with younger (estimate [SE] = 8.011 [2.485], P = 0.006), preoperative lens drop (estimate [SE] = 8.621 [2.906], P = 0.009), idiopathic cataract (estimate [SE] = 6.021 [2.099], P = 0.048), high baseline Early Treatment Diabetic Retinopathy Study letters (estimate [SE] = 15.449 [2.352], P < 0.001), or low baseline SE (estimate [SE] = 6.357 [2.406], P = 0.018) had the greatest improvement in Early Treatment Diabetic Retinopathy Study letters during follow-up. Patients with preoperative lens or IOL dislocation had a greater postoperative SE improvement than those with preoperative lens or IOL subluxation (dislocation vs. subluxation: estimate [SE] = -189.235 [70.692], P = 0.016). There were no cases of vitreous hemorrhage, cystoid macular edema, endophthalmitis, subluxation, or dislocation were observed during the 6-month follow-up. Conclusion: This modified IOL scleral fixation technique is a simple, safe, and efficient method that avoids haptic manipulation and slippage, reduces postoperative complications, achieves completely sutureless surgery, and results in an achievement of surgical refractive goals.