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Iris Fixation of a Subluxed 3-piece Intraocular Lens Utilising a Modified Siepser Sliding Knot

  Channels: Cataract Surgery | Posted 7/10/2013

A 46-year old man with a previous penetrating eye injury was seen in clinic complaining of monocular diplopia and poor visual quality. He had undergone primary repair as well as lensectomy and IOL placement in the ciliary sulcus. Slit lamp examination showed a subluxed sulcus 3-piece IOL. A decision was made to suture the existing IOL to the iris. A temporal clear cornea incision was made and the IOL optic prolapsed into the anterior chamber using a viscoelastic cannula, with OVD used to protect the corneal endothelium. A 10/0 prolene suture on a CIF4 needle (Ethicon Inc), was used to suture each haptic to the iris. A modified siepser sliding knot was utilized using micro-instrumentation to complete internal docking and suture completion. Two such sutures were performed (one for each haptic) after which the IOL optic was prolapsed back into the ciliary sulcus. The OVD was thereafter removed and that concluded the case. The patient was seen 3 days postoperatively with complete resolution of his monocular diplopia and an improvement in visual quality with a stable well centered lens. The situation was unchanged at his last follow up three months after surgery.

Dislocated IOL, subluxed IOL • Ocular trauma • Trauma

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