Purpose: to develop a marker for centration and symmetric implantation of intraocular lens in transscleral fixation.
Method: A self-designed marker was developed. The marker was designed for the identification of corneal center and the two symmetric ports 1.0 mm from the surgical limbus. After fornix-based conjunctival flaps are created at the nasal and temporal limbus, corneal center and the two symmetric marks were identified by the self-designed marker. Anterior chamber maintainer was used to maintain the anterior chamber. The 9-0 polypropylene sutures were placed symmetrically through the scleral bed marked by the self-designed marker using ab externo technique. Intraocular lens was fixed by the symmetrically introduced sutures. The method was evaluated by 18 eyes of 18 patients. 12 eyes were implanted with Alcon CZ70BD, 6 eyes were implanted with black diaphragm intraocular (Morcher,67G)lens. Postoperative anterior segment digital photographs were obtained with retro-illumination technique. The digital photos were analyzed by a template protractor using Adobe Photoshop to evaluate the centration and symmetric implantation of IOLs.
Results: The duration of the operation ranged from 23 to 53 min, with a mean of 33.5±8.5 min. Three cases of mild to moderate vitreous haemorrhage were detected and followed up till resolution. Suture erosion, postoperative endophthalmitis, cystoid macular oedema, retinal detachment or IOL dislocation were not detected in any case. All IOLs were well centered and symmetric implanted. Average postoperative decentration of IOL detected by digital protractor was 0.6±0.27mm (range from 0 to1.5mm).
Conclusions: Identification of fixation ports using the self-designed marker for is a reliable method for the implantation of scleral sutured IOLs.