We describe 4-point scleral fixation of a posterior chamber intraocular lens (PC IOL) using 8-0 polypropylene (Prolene) sutures, without the handshake technique. First, 4 sclerotomy sites are marked 2.5 mm from the limbus, and 2 scleral grooves are created in between. Two sets of 8-0 polypropylene sutures are then passed through the IOL haptics. The PC IOL is inserted behind the iris, and the sutures are pulled ab interno and tightened for optimum IOL centration. The sutures and exposed knots are imbedded within the scleral groove and sealed with fibrin glue. This 4-point scleral fixation technique was performed uneventfully in 9 cases (4 men, 5 women; mean age 71.4 years ± 12.2 [SD]) and the PC IOL was stable for 10 months (range 8 months to 1 year) with no signs of IOL subluxation, dislocation, tilt, or suture-related complications such as erosion or infection.
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