G. Condon's tips on scleral fixating IOL's
Steinerts discussion of Scleral fixation of dislocated sulcus IOL's
Ethicon's needle inventory page:
consider the CIF-4 10-0 prolene 10mm curved needle
or STC-6 or CTC-6L 10-0 prolene curved 13 mm needle
Monday, March 31, 2008
Wednesday, March 26, 2008
IRIS SUTURING ~ IRIS FIXATED IOLS
In the event there is no remaining anterior or posterior capsule for sulcus support, consider . . . .
IRIS Suturing of decentered sulcus IOL
My personal technique utilizes an Ethicon 10-0 prolene suture on a curved long 14mm needle (fairly sturdy for its diameter and easy to retrieve across the limbus). Packer et al. describe placing peripheral corneal incisions 2 clock hours counterclockwise from the haptic one desires to capture, and passing the needle into the AC, retrieving it 1 clock hour clockwise in a similar sideport incision. I have found it advantageous to pass a 25 gauge needle tip into the receiving sideport incision to help facilitate the prolene needle tip re-surface anterior to the iris plane. After this maneuver, it is much easier to guide the prolene suture out of the AC with a ruff of iris and haptic captured by the needle pass. Place your favorite suture to secure the haptic, Siepser, McCannel or Western knots. I have found the Siepser to allow a tighter knot than the McCannel given that one can place more horizontal tension on the throws. ~ DJW
Packer et al. Favorite tricks for Iris suturing
Google Book: Complications in Phaco pp. 209
Changs Write-up of Siepser Slip Knot in Iris Sutured IOL's
R. Horn description of Western Knot in Iris Suturing
D. Azar's description of suturing a plate haptic IOL to Iris
IRIS Suturing of decentered sulcus IOL
My personal technique utilizes an Ethicon 10-0 prolene suture on a curved long 14mm needle (fairly sturdy for its diameter and easy to retrieve across the limbus). Packer et al. describe placing peripheral corneal incisions 2 clock hours counterclockwise from the haptic one desires to capture, and passing the needle into the AC, retrieving it 1 clock hour clockwise in a similar sideport incision. I have found it advantageous to pass a 25 gauge needle tip into the receiving sideport incision to help facilitate the prolene needle tip re-surface anterior to the iris plane. After this maneuver, it is much easier to guide the prolene suture out of the AC with a ruff of iris and haptic captured by the needle pass. Place your favorite suture to secure the haptic, Siepser, McCannel or Western knots. I have found the Siepser to allow a tighter knot than the McCannel given that one can place more horizontal tension on the throws. ~ DJW
Packer et al. Favorite tricks for Iris suturing
Google Book: Complications in Phaco pp. 209
Changs Write-up of Siepser Slip Knot in Iris Sutured IOL's
R. Horn description of Western Knot in Iris Suturing
D. Azar's description of suturing a plate haptic IOL to Iris
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