Intra-scleral fixation of the iris hooks for trans-scleral capsular bag fixation in patient with zonular dialysis

Abstract

To report a technique of intra-scleral fixation of the iris hooks for trans-scleral capsular bag fixation in patient with zonular dialysis. Two scleral flaps, two scleral tunnels and two sclerotomies were formed. The anterior capsule was captured and pulled by the iris hooks resulting in the IOL adopting an appropriate position at which point the iris hooks extracted from the sclerotomies. The tips of the iris hooks were implanted into the scleral tunnels. Each of them was fixed with a 10.0 nylon suture to the scleral bed. The scleral flaps and conjunctiva were sutured. One of the iris hooks was seen loosened at the first-week postoperative examination but the IOL remained centralized. The loosened hook was removed. No complications were witnessed during the patient's 24-month follow-up. Intra-scleral fixation using iris retractors in the capsular bag for patients having suffered dislocation of IOL despite the attachment of a capsular hook because of zonular dialysis can be safely implemented.