Flanged Polypropylene Suture for Preset One-Piece Acrylic Intraocular Lens Fixation with Pre-Threaded Needle Technique: Surgical Technique and Short-Term Clinical Outcomes.

Purpose: This study aimed to report the feasibility and short-term clinical outcomes of a novel technique for one-piece intraocular lens (IOL) fixation using double-threaded 30-gauge needles and flanged polypropylene sutures. Patients and Methods: Forty eyes of 38 consecutive patients with subluxated crystalline lenses, dislocated IOLs, or aphakia were included. Two 30-gauge needles pre-threaded with 7-0 polypropylene sutures were inserted 2.4 mm posterior to the limbus horizontally toward the center of the globe. After the suture loops were externalized, a preset one-piece IOL was inserted into the anterior chamber. Both haptics were then externalized, tied with a 2-1-1 knot, and reinserted. The sutures were pulled to center the IOL, cut, cauterized to form flanges, and buried in the sclera. Results: Uncorrected visual acuity improved from 1.25 ± 0.55 logMAR preoperatively to 0.81 ± 0.52 logMAR at 3 months postoperatively. Best-corrected visual acuity changed from 0.72 ± 0.66 to 0.39 ± 0.48 logMAR. The mean refractive difference was 0.25 ± 0.67 D. The mean IOL decentration and tilt were 0.34 ± 0.20 mm and 7.25° ± 3.4°, respectively. Flange erosion was observed in four eyes (10.0%), retinal detachment in one eye (2.5%), and cystoid macular edema in one eye (2.5%). No postoperative IOL dislocation or clinical signs suggestive of iris chafing were seen during follow-up. Conclusion: In this short-term series, the technique allowed fixation of a one-piece IOL with acceptable centration and no postoperative IOL dislocation. The technique may be an option when three-piece IOLs are unavailable or when preservation of an existing one-piece IOL is desirable.