Cable tie technique for securing scleral fixation suture to intraocular lens

PURPOSE: To report a new flanged intrascleral fixation technique for subluxated or dislocated intraocular lens (IOL) with c-loop or double c-loop haptics (cable tie fixation method). OBSERVATIONS: We introduced a cable tie fixation method using 6–0 polypropylene for subluxated multifocal IOL with C-loop or double C-loop haptics. After passing the 6–0 polypropylene monofilament under the optic-haptic junction, the other end of the strand was taken out of the eye after passing it above the optic-haptic junction. A knot was made at one end, and the opposite strand was passed through the knot to form a loop. Both ends of the monofilament were tugged to make the loop fixed to the optic-haptic junction smaller. Both ends of the monofilament were externalized 2.5 mm posterior to the limbus using a 30 G needle. Another 6–0 polypropylene monofilament was tied to the opposite optic-haptic junction and scleral fixation was performed. While checking the IOL centration, the four ends of the 6–0 polypropylene monofilaments were heated with a cautery to form flanges. CONCLUSIONS AND IMPORTANCE: A four-flanged intrascleral fixation technique involving a cable tie-shaped loop using 6–0 polypropylene could provide stable IOL fixation without damage for subluxated or dislocated IOLs with C-loop or double C-loop haptics.