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Double Belt Loop Scleral Fixation of a Subluxated IOL and Goniotomy for Pseudoexfoliation Glaucoma

Edward Yung, MD

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In this video, a patient presented with elevated IOP and spontaneous complete inferior subluxation of his IOL due to pseudoexfoliation. His vision decreased to count fingers due to IOL malpositioning. Examination revealed an in-the-bag IOL with a capsular tension ring placed at the time of cataract surgery. To avoid difficult removal of this IOL and capsule, Edward Yung, MD, decided to preserve the in-the-bag IOL and scleral fixate it using a double belt loop procedure. Pars plana vitrectomy was carried out to clear any prolapsed vitreous to facilitate proper centration of the IOL. A KDB Glide (New World Medical) was then used to perform an excisional goniotomy to address his elevated IOP at the same time.

Financial Disclosure: Consultant (New World Medical)

Posted: 7/28/2025

Keywords:

Belt Loop Refixation

•

Dislocated IOL, subluxed IOL

•

Goniotomy

•

Pseudoexfoliation Syndrome, PXF

•

MIGS

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Double Belt Loop Scleral Fixation of a Subluxated IOL and Goniotomy for Pseudoexfoliation Glaucoma

Edward Yung, MD

In this video, a patient presented with elevated IOP and spontaneous complete inferior subluxation of his IOL due to pseudoexfoliation. His vision decreased to count fingers due to IOL malpositioning. Examination revealed an in-the-bag IOL with a capsular tension ring placed at the time of cataract surgery. To avoid difficult removal of this IOL and capsule, Edward Yung, MD, decided to preserve the in-the-bag IOL and scleral fixate it using a double belt loop procedure. Pars plana vitrectomy was carried out to clear any prolapsed vitreous to facilitate proper centration of the IOL. A KDB Glide (New World Medical) was then used to perform an excisional goniotomy to address his elevated IOP at the same time.

Financial Disclosure: Consultant (New World Medical)

Posted: 7/28/2025

Keywords:

Belt Loop Refixation

•

Dislocated IOL, subluxed IOL

•

Goniotomy

•

Pseudoexfoliation Syndrome, PXF

•

MIGS

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