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Suture snare technique for scleral fixation of intraocular lenses and capsular tension devices
  1. Soon-Phaik Chee1,2,3,4,
  2. Nicole Shu-Wen Chan1
  1. 1 Singapore National Eye Centre, Singapore, Singapore
  2. 2 Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
  3. 3 Singapore Eye Research Institute, Singapore, Singapore
  4. 4 Duke-NUS Medical School, Singapore, Singapore
  1. Correspondence to Professor Soon-Phaik Chee, Singapore National Eye Centre, Singapore 168751, Singapore; chee.soon.phaik{at}singhealth.com.sg

Abstract

Polytetrafluoroethylene (Gore-Tex) suture is preferred for scleral fixation of intraocular lenses or capsular tension devices as it is more resilient to breakage than polypropylene 10–0. However, manipulation of the thick calibre and overcurved configuration of the Gore-Tex needle within the eye poses a risk of damage to the intraocular structures. Existing techniques that overcome the problem of needles within the anterior chamber involve special instruments to retrieve the suture. We describe a technique that creates a suture snare from a short segment of the Gore-Tex suture borne on a 26-gauge needle, which is used to retrieve the Gore-Tex suture safely at the scleral fixation site. The suture is threaded into the bore of the needle leaving a short length extending from the hub which is secured by inserting a 1 cc syringe acting as a handle. The needle is inserted at the scleral fixation site, and the suture trailing from the needle tip forms a loop which is externalised at the main incision. This suture snare is used to retrieve the end of the Gore-Tex suture bearing the device to the scleral fixation site when the needle and the loop of the suture are withdrawn from the eye. This technique eliminates the inappropriate needle and the need for a large sclerostomy, and is cost-effective and can also be used in combination with the conjunctival-sparing Hoffman corneoscleral pocket.

  • Gore-Tex
  • polytetrafluoroethylene
  • suture snare
  • scleral fixation
  • subluxated cataract
  • subluxated intraocular lens

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Footnotes

  • Contributors S-PC was involved in the conception and design of the technique, drafting the manuscript and critical revision for important intellectual content. NS-WC contributed to the design of the work, drafting of the manuscript and critical revision for important intellectual content. Both authors have approved the final version published and agree to be accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests S-PC is a speaker for AbbVie, Alcon Laboratories, Allergan, Bausch and Lomb Technolas, Carl Zeiss Meditec, Hoya Surgical Optics, Johnson & Johnson Vision, Santen Pharmaceutical and Ziemer Ophthalmic Systems. NS-WC has no financial or proprietary interest in any material or method mentioned. 

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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