Flanged iris hook for capsular bag stabilization

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.

Attaining the optimal flange technique for transscleral capsular bag stabilization using iris hooks

“…Soyler et al and Krix-Jachym et al, who both presented techniques with flanged iris hooks for the stabilization of the capsular bag using either a capsular tension ring or a capsular tension segment, used the same PP iris hooks for intrascleral fixation that we tested in this study. 4,5 Our study therefore supports the suitability of these PP iris hooks for their techniques along with their already existing real-life experience with the respective hooks.…”

“…3 This approach yields the advantage of preserving the capsular bag during surgery in cases with zonular dialysis or subluxated crystalline lenses. As a modification of this initially introduced technique using sutures to secure the iris hooks to the sclera, fixation techniques using flanged iris hooks for vertical capsular support have been proposed by Soyler et al and Krix-Jachym et al 4,5 In contrast to capsular tension rings, which are used in eyes with up to 90 degrees of zonular dialysis for horizontal capsular support, capsular hooks or iris hooks enable stabilization in more encompassing cases of zonular dialysis aiding external support. 3 There are also dedicated capsule fixation devices, such as the Cionni capsular tension ring with extra eyelets for fixation or the Assia anchor and the Ahmed ring segment that have been used for supporting instable capsules; however, these need to be held in stock for use and may not be as widely available as iris hooks which are in use much more commonly.…”