Angelina Meireles, João Melo-Beirão, Natália Ferreira, Bernardete Pessoa


Scleral fixation of a foldable IOL through a small clear corneal incision in eyes without zonular support.


In ten eyes of nine patients a single-piece foldable IOL was implanted  through a small clear corneal incision and fixated to the sclera. To secure the implant a knotless technique was done. First, a bow with knot in each haptic is first done using a 10-0 polypropylene double-armed suture. Both needles passed the sclera at 1,5mm from the limbus and 180ª apart each other. Then the IOL is inserted and positioned in the sulcus. After that the needle is passed intrascleraly in a zig-zag shape. After five indentations the suture is cut without any knot.

Effectiveness / Safety:

All eyes, except one achieved good fixation of the implant. None of the patients, except one, developed major complications during or after the IOL implantation. The technique shows good IOL stability, a rapid visual rehabilitation and lower risk of scleral complications.