Modified Technique for Sutured Intraocular Lens

Purpose: To describe a novel scleral fixation technique for the Akreos AO60 intraocular lens (IOL) using Gore-Tex sutures buried within the sclera to minimize long-term exposure-related complications and improve cosmetic outcomes. Methods: Four eyes of four patients underwent scleral fixation of the Akreos AO60 lens using the modified ab externo approach. Outcomes included best-corrected visual acuity (BCVA), IOL centration, and suture-related complications. Results: Preoperative BCVA ranged from 20/60 to 20/300. Postoperative BCVA ranged from 20/30 to 20/90 at final follow-up. All IOLs remained well-centered with no visible suture on external exam. One patient developed transient postoperative hypotony and a macula-off retinal detachment one month after lens fixation, which was successfully repaired with pars plana vitrectomy. No patients required additional surgery related to the IOL or suture material. Conclusion: The described technique allows secure scleral fixation of the Akreos AO60 IOL while minimizing the risk of Gore-Tex suture exposure. This modification may improve long-term outcomes and cosmesis.