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Schlatter A, Kronschläger M, Ruiss M, Bayer N, Blouin S, Findl O. Attaining the optimal flange technique for transscleral capsular bag stabilization using iris hooks. J Cataract Refract Surg 2024; 50:295-300. [PMID: 37994093 PMCID: PMC10878459 DOI: 10.1097/j.jcrs.0000000000001367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/05/2023] [Accepted: 11/09/2023] [Indexed: 11/24/2023]
Abstract
PURPOSE To investigate the flange properties of different iris hooks. SETTING Vienna Institute for Research in Ocular Surgery (VIROS), Hanusch Hospital, Vienna, Austria. DESIGN Laboratory study. METHODS The flanging properties of 4 different iris hooks made from polypropylene (PP), elastic polymer (EP), and nylon were investigated with different heating distances and both with and without forceps gripping. The maximum diameter of the flanges was measured, and the shape of the flanges was evaluated. RESULTS Although both nylon and EP iris hooks had too small flange diameters for intrascleral fixation, PP iris hooks had a sufficient flange diameter (>330 μm) and mushroom-like shape. Furthermore, in PP hooks, heating distance was directly proportional to flange diameter. CONCLUSIONS The findings of this study suggest that only PP iris hooks are suitable for flanged intrascleral fixation, which is off-label, to secure adequate fixation.
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Affiliation(s)
- Andreas Schlatter
- From the Vienna Institute for Research in Ocular Surgery (VIROS), Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria (Schlatter, Kronschläger, Ruiss, Bayer, Findl); Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of ÖGK and AUVA Trauma Centre Meidling, 1st Medical Department, Hanusch Hospital, Vienna, Austria (Blouin)
| | - Martin Kronschläger
- From the Vienna Institute for Research in Ocular Surgery (VIROS), Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria (Schlatter, Kronschläger, Ruiss, Bayer, Findl); Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of ÖGK and AUVA Trauma Centre Meidling, 1st Medical Department, Hanusch Hospital, Vienna, Austria (Blouin)
| | - Manuel Ruiss
- From the Vienna Institute for Research in Ocular Surgery (VIROS), Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria (Schlatter, Kronschläger, Ruiss, Bayer, Findl); Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of ÖGK and AUVA Trauma Centre Meidling, 1st Medical Department, Hanusch Hospital, Vienna, Austria (Blouin)
| | - Natascha Bayer
- From the Vienna Institute for Research in Ocular Surgery (VIROS), Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria (Schlatter, Kronschläger, Ruiss, Bayer, Findl); Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of ÖGK and AUVA Trauma Centre Meidling, 1st Medical Department, Hanusch Hospital, Vienna, Austria (Blouin)
| | - Stéphane Blouin
- From the Vienna Institute for Research in Ocular Surgery (VIROS), Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria (Schlatter, Kronschläger, Ruiss, Bayer, Findl); Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of ÖGK and AUVA Trauma Centre Meidling, 1st Medical Department, Hanusch Hospital, Vienna, Austria (Blouin)
| | - Oliver Findl
- From the Vienna Institute for Research in Ocular Surgery (VIROS), Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria (Schlatter, Kronschläger, Ruiss, Bayer, Findl); Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of ÖGK and AUVA Trauma Centre Meidling, 1st Medical Department, Hanusch Hospital, Vienna, Austria (Blouin)
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Soyler M, Sabur H, Unsal U. Flanged iris hook for capsular bag stabilization. J Cataract Refract Surg 2022; 48:1088-1091. [PMID: 36026473 DOI: 10.1097/j.jcrs.0000000000000985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 06/01/2022] [Indexed: 11/26/2022]
Abstract
A new surgical technique was demonstrated for fixating the capsular bag to the sclera using a capsular tension segment (CTS) and a flanged iris hook. In a patient with a 180-degree zonular dialysis, a capsular tension ring was implanted into the capsular bag, and a CTS was placed into the zonular dialysis area after cataract removal. Then, an iris hook was directed to the anterior chamber through a side port opposite the zonular dialysis area. After the hook tip was placed into the eyelet of the CTS, a 30-gauge injector was used to guide the hook tip out. Tension was adjusted to ensure the capsular centralization, and a flange was created using cautery. Finally, the procedure was completed by embedding the flange into the sclera. This method is simple, minimally invasive, and time-saving by eliminating the scleral suturing, scleral flaps, or large conjunctival dissections.
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Affiliation(s)
- Mehmet Soyler
- From the Department of Ophthalmology, Batigoz Eye Health Center, Izmir, Turkey (Soyler, Unsal); Department of Ophthalmology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey (Sabur)
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Sutureless technique for repositioning and scleral fixation of the capsular bag-intraocular lens complex with permanent use of iris retractors. J Cataract Refract Surg 2022; 48:118-124. [PMID: 34855644 DOI: 10.1097/j.jcrs.0000000000000838] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 09/05/2021] [Indexed: 11/26/2022]
Abstract
A new sutureless technique used for repositioning and scleral fixation of the capsular bag-intraocular lens (IOL) complex in the surgical treatment of subluxated lenses is described. Iris retractors were used not only to induce a tent effect on the capsule but also to permanently fix the capsular bag to the sclera in this method, without the need to prepare scleral or conjunctival flaps. Surgery with the use of a capsular tension ring (CTR) and iris retractors, the ends of which were brought out through the sclera and cauterized, was performed in 7 eyes of 7 patients with moderate or severe subluxation of the crystalline lens. In all cases, simultaneous use of a CTR and iris retractors ensured good centration of the capsular bag-IOL complex. The method was safe and effective in fixing the capsule to the sclera in the case of significant damage to the ligamentous apparatus of the lens.
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Sevimli N, Karadag R, Çakıcı Ö. A review of techniques and challenges in performing sutureless intrascleral fixation of intraocular lens. EXPERT REVIEW OF OPHTHALMOLOGY 2021. [DOI: 10.1080/17469899.2021.1999807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Neslihan Sevimli
- Ophthalmology, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | | | - Özgür Çakıcı
- Ophthalmology, Medeniyet University Göztepe Training and Research Hospital, Istanbul, Turkey
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