Injectable Suture for Scleral Fixation of an IOL

Monday, April 20, 2015: 3:16 PM
Room 5A (San Diego Convention Center)
Michael Erlanger, MD
Jeffrey L. Olson, MD

To describe a novel device and technique to achieve scleral fixation of an intraocular lens. The device consists of an injectable polypropylene suture in a preformed hitch with a silicone bolster. The suture is injected through the pars plana and tied to seal the wound with a buried knot.

The device was developed and tested using IACUC approval exempt porcine eyes in the laboratory setting. An IOL was inserted into an enucleated porcine eye in which the crystalline lens had been removed. Two sclerotomies were made 1.5 mm posterior to the limbus using an MVR blade.  The 24-gauge injector delivered the preformed suture loop into the eye. The polypropylene IOL haptic was then secured through the loop, using a micro-forceps. The loop in the suture was tightened around the haptic, and the needles were used to both fixate the lens to the sclera and close the sclerotomy.

The surgical procedure was able to be completed with the IOL preplaced simulating a repositioning of a subluxed IOL and with insertion of an IOL representing secondary IOL placement in an aphakic eye. The procedure resulted in a securely scleral fixated IOL in both scenarios. The double armed polypropylene suture was used for scleral fixation and to close the sclerotomies with a buried knot. During mechanical stress testing, the IOL was found to be stable with no slippage of the haptic or suture observed.

This new surgical technique and new technology of a 24-gauge suture injector allows for the delivery a 10-0 polypropylene preformed hitch suture. This technique allows for rapid and secure scleral fixation of an IOL in an intact, closed chamber porcine eye.