Intra-scleral fixation of the iris hooks for trans-scleral capsular bag fixation in patient with zonular dialysis

Abstract

Intra-scleral fixation using iris retractors in the capsular bag for patients having suffered dislocation of IOL despite the attachment of a capsular hook because of zonular dialysis can be safely implemented.

Flanged iris hook for capsular bag stabilization

“…Another technique for capsular bag stabilization using an iris hook was described by Karadag et al 12 However, unlike our technique, they created a scleral flap and sutured the iris hook under the scleral flap. Recently, Krix-Jachym et al have also described a new method using a CTR and a flanged iris hook.…”

Sutureless technique for repositioning and scleral fixation of the capsular bag–intraocular lens complex with permanent use of iris retractors

“…The scleral flaps and conjunctiva were sutured. 18 Similarly, as Karadag, we preferred to use iris retractors more than capsular hooks due to their smaller and narrower hook part.…”

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

“…Two more recent reports investigating the longterm safety of surgical procedures involving nylon or PP sutures with small samples did not report on complications arising from biodegradation of the used materials. 3,20 By contrast, Price et al reported late dislocations of PP scleral-sutured posterior chamber IOLs in 5 cases. 21 Nevertheless, the comparability to this study is reduced, as Price et al reported on 10-0 PP sutures, which are significantly thinner than the iris hooks investigated in this study.…”

“…2 Besides the secondary fixation of IOLs, a new technique for scleral stabilization of the capsular bag and IOL centration has been proposed by Karadag et al using 2 iris hooks sutured to the scleral bed. 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.…”

“…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. [6][7][8] Commercially available iris hooks consist of different materials.…”