Repositioning dislocated rigid C- loop intraocular lens using double rectangle prolene 10–0 sutures: A novel technique
Pietro Maria Talli, Antonio Cartabellotta, Francesco Nasini, Sami Al-Nawaiseh, Jacopo Dell'Uomo, Laura Sarti, Ginevra Giovanna Adamo, Marco Pellegrini, Marco MuraPurpose
To describe a novel technique for repositioning dislocated rigid C-loop polymethyl methacrylate (PMMA) intraocular lenses (IOLs) without eyelets using a double-rectangle 10–0 prolene suture configuration.
Methods
This retrospective observational study included six eyes of patients with dislocated rigid C-loop PMMA IOLs in the vitreous cavity. All eyes underwent pars plana vitrectomy and repositioning of the existing IOL using a double-rectangle 10–0 prolene suture configuration, securing the IOL between the suture and the iris. Postoperative evaluation included best-corrected visual acuity (BCVA), slit-lamp biomicroscopy, fundoscopy, anterior segment optical coherence tomography (AS-OCT), and posterior segment OCT. IOL tilt and postoperative complications were assessed during follow-up.
Results
At 12 months follow up all six IOLs were successfully repositioned intraoperatively. No complete IOL redislocation occurred during the available follow-up. Final BCVA was 0.14 ± 0.08 logMAR, and the mean IOL tilt was 2.43° ± 1.58°. A myopic refractive shift of 1.75 ± 0.22 D was observed compared with the pre-dislocation refraction. One eye (16.7%) developed partial inferior IOL subluxation, without associated visual or refractive deterioration, and two eyes (33.3%) developed cystoid macular edema, resolved with treatment.
Conclusion
In this small proof-of-concept series, the double-rectangle 10–0 prolene suture technique allowed repositioning of dislocated rigid C-loop PMMA IOLs while avoiding a large corneal incision and was associated with favorable short-term anatomical outcomes. The occurrence of CME and partial IOL subluxation highlights the need for careful postoperative monitoring. Larger studies with longer follow-up are required to determine the long-term stability, safety, and reproducibility of the technique.