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Evaluations of bridging sutures in preventing iris capture in eyes with intrascleral fixation of implanted intraocular lens

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Abstract

Purpose

The study aims to determine the effectiveness of bridging sutures in preventing iris capture and a subsequent reverse pupillary block after an intrascleral fixation of an implanted intraocular lens (IOL).

Methods

We studied 6 eyes that had an iris capture with reverse pupillary block due to a dislocated IOL after an intrascleral fixation. After the dislocated IOL was repositioned, 10–0 polypropylene sutures were inserted 1.5 mm posterior to the limbus and directed to run between the iris and the IOL. The sutures were placed orthogonal to the haptics of the IOL. Anterior segment optical coherence tomography (AS-OCT) was used in 4 eyes to evaluate the degree of iridodonesis before and after the bridging sutures. The heights of the temporal and nasal sectors of the middle iris from the iris plane (the line between anterior chamber angles) were compared for each 0.2-s AS-OCT image taken immediately after the eye moved from a lateral to a primary position.

Results

None of the eyes had a recurrence of the iris capture after the bridging sutures. The refractive error, anterior chamber depth, and vision were not significantly altered after the bridging sutures were placed. The AS-OCT images showed that the height of the nasal iris was decreased more at 0 s postoperatively blocking the excessive downward movement of the nasal iris but not the iridodonesis.

Conclusion

Bridging sutures were effective in preventing iris capture and subsequent reverse pupillary block after an intrascleral fixation of an IOL.

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Acknowledgements

The authors thank Professor Emeritus Duco Hamasaki of the Bascom Palmer Eye Institute, University of Miami, Miami, Florida, for the discussions and thorough editing of the manuscript.

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Authors and Affiliations

  1. Kyorin Eye Center, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan

    Makoto Inoue, Takashi Koto & Akito Hirakata

  2. Department of Ophthalmology, Tokyo Dental College Suidobashi Hospital, Tokyo, Japan

    Makoto Inoue, Yuka Ota & Hiroko Bissen-Miyajima

Authors
  1. Makoto Inoue
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  2. Takashi Koto
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  4. Hiroko Bissen-Miyajima
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  5. Akito Hirakata
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Contributions

M. I. have contributed to the conception and design, acquisition of data, analysis and interruption of data, drafting the manuscript, and critically reviewing the manuscript. T. K. has contributed to the analysis and interruption of data and drafting of the manuscript. Y. O. has contributed to the analysis and interruption of data. H. B.-M. has contributed to the conception and design and critically reviewed the manuscript. A. H. has contributed to the conception and design and critically reviewed the manuscript.

Corresponding author

Correspondence to Makoto Inoue.

Ethics declarations

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. All the procedures in this study were approved by the Institutional Review Committee of the Kyorin University School of Medicine.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

Author M. I. has received a research grant and lecture fees from Alcon Laboratories and a speaker honorarium from Alcon Pharma, Novartis, HOYA Medical, Senjyu Pharmaceutical Co., Ltd., Bayer, Santen Pharmaceutical Inc., Carl Zeiss Meditec, Logic and Design, outside the submitted work. Author T. K. has received a speaker honorarium from Alcon Lab, AMO, HOYA, Santen, Senjyu, KOWA, Carl Zeiss, Novartis, and Bayer, outside the submitted work. Author Y. O. has received no conflict of interest. Author H. B.-M. has received a research grant from Alcon Laboratories, Santen, HOYA, consultant of Alcon Laboratories, HOYA, and Carl Zeiss Meditec and a speaker honorarium from Alcon Lab, AMO, HOYA, Santen, Senjyu, KOWA, and Carl Zeiss, outside the submitted work. Author A. H. has received a research grant and a speaker honorarium from Santen Pharmaceutical Inc. and lecture fees from Alcon Laboratories, Novartis, Senjyu, Bayer, and Kowa, outside the submitted work.

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Inoue, M., Koto, T., Ota, Y. et al. Evaluations of bridging sutures in preventing iris capture in eyes with intrascleral fixation of implanted intraocular lens. Graefes Arch Clin Exp Ophthalmol 261, 427–434 (2023). https://doi.org/10.1007/s00417-022-05816-1

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