Four-Flanged Intrascleral Intraocular Lens Fixation Technique: No Flaps, No Knots, No Glue

Purpose: To develop a novel, sutureless, single-piece, nonfoldable intraocular lens (IOL) intrascleral fixation technique based on the existing Malbran IOL scleral fixation and Yamane double-needle techniques. Methods: The novel method uses a 5.0 polypropylene suture and a bipolar cautery to create 2 flanges in the eyelets of the IOL and 2 flanges outside to insert inside the scleral tunnel and thus fixate the IOL. Results: This technique had been applied in 4 patients with aphakia after phacoemulsification complications. The mean preoperative and postoperative corrected distance visual acuities were 0.45 +/- 0.17 and 0.67 +/- 0.27 (Snellen decimal units), respectively. Conclusions: The 4-flanged technique improves and simplifies the existing single-piece, nonfoldable IOL intrascleral fixation techniques.