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Intraocular lens dislocation: a novel in-situ scleral refixation technique using a 25 Gauge trocar in the anterior chamber
  1. Fabrizio Giansanti1,
  2. Ruggero Tartaro1,
  3. Tomaso Caporossi1,
  4. Vittoria Murro1,
  5. Alfonso Savastano1,
  6. Francesco Barca1,
  7. Daniela Bacherini1,
  8. Tito Fiore2,
  9. Carlo Cagini2,
  10. Stanislao Rizzo1
  1. 1 Dipartimento Neuromuscoloscheletrico e Organi di Sensi, Università degli Study di Firenze, Florence, Italy
  2. 2 Division of Ophthalmology, Department of Surgery and Biomedical Science, University of Perugia, S Maria della Misericordia Hospital, Perugia, Italy
  1. Correspondence to Ruggero Tartaro; ruggero.tartaro{at}


Objective Intraocular lens (IOL) repositioning using a closed-eye approach could be carried out in some selected cases. Our study focuses on the efficacy and safety of a IOL closed-eye repositioning technique using scleral suture, which is performed using a trocar as an intrastromal limbal guide.

Methods and analysis Thirty-one eyes of 31 patients with late IOL dislocation operated on between January 2015 and May 2017 were included in this retrospective non-comparative consecutive case series study. The patients had a single-piece in-the-bag dislocation or a 3-pieces in-the-bag or out-of-the-bag dislocation. The patients underwent an anterior vitrectomy and a scleral refixation in a closed chamber using a 10/0 polypropylene suture passed through a 25 Gauge trocar inserted in the anterior chamber.

Results The mean follow-up time was 19.54 months. Average preoperative best-corrected visual acuity (BCVA) was 0.73 LogMar (±0.21 SD); while average postoperative BCVA was 0.27 LogMar (±0.23 SD). Fifteen patients underwent anterior pars plana vitrectomy (PPV) while 16 patients did not; moreover, two patients underwent PPV. Six patients had an increase of postoperative intraocular pressure, two patients had postoperative decentration, two patients had postoperative cystoid macular oedema, none of the patients had major complications such as retinal detachment, choroidal detachment, malignant glaucoma, irreversible corneal decompensation and endophthalmitis.

Conclusion We can affirm that our technique may be safe and useful in the case of 3-piece in-the bag or out-of the bag dislocated IOLs and also in the case of in-the-bag single-piece dislocated IOLs.

  • IOL dislocation
  • IOL sub-luxation
  • scleral fixation technique
  • via pars plana vitrectomy
  • polypropylene durability

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  • Contributors SR and FG planned the study. FB, TC, SR and FG performed the surgical procedures. RT, AS, VM, DB, CC and TF collected the data and wrote the manuscript.

  • 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.

  • Disclaimer None of the authors has commercial associations that might pose a conflict of interest in connection with the submitted paper. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

  • Competing interests None declared.

  • Patient consent Not required.

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

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