The Balanced Two-String Technique for Sulcus Intraocular Lens Implantation in the Absence of Capsular SupportReportar como inadecuado

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Journal of Ophthalmology - Volume20152015, Article ID153963, 5 pages -

Clinical StudyDepartment of Ophthalmology, Faculty of Medicine, Alexandria University, Raml Station, Alexandria, Egypt

Received 4 December 2014; Accepted 5 January 2015

Academic Editor: MehmetBorazan

Copyright 2015 Hesham A. Ibrahim and Heba Nabil Sabry. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Purpose. To describe and explore an alternative approach for sulcus intraocular lens IOL implantation in the absence of capsular support. Methods. The commonly available one-piece polymethyl methacrylate PMMA lens is stabilized in the sulcus by two intraocular horizontal strings of 10-0 polypropylene suture passed through the lens dialing holes in opposite directions to achieve a mechanical balance. The horizontal strings of 10-0 polypropylene work as a rail track for the IOL optics, allowing some side to side lens adjustment even following wound closure. The stability of the IOL was tested in vitro. Six aphakic patients underwent in-sulcus IOL secondary implantation using the balanced two-string technique. Patients were followed up for a minimum of six months. Best spectacle corrected vision was assessed. Lens centration and lens tilt were measured by anterior segment optical coherence tomography AS-OCT. Results. All patients had successful lens insertion. Best spectacle corrected visual acuity BSCVA improved in all patients. Lens decentration ranged between 0.21mm and 0.9mm average 0.53mm. Lens tilt ranged between 1.2 and 2.8 average 2.17. Conclusion. The mechanically balanced two-string technique is an alternative option for sulcus IOL implantation in absence of capsular support, allowing lens centration adjustment with no additional risks.

Autor: Hesham A. Ibrahimand Heba Nabil Sabry



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