Suture Pull-Through Technique for EndoArt Insertion in a Complex Case Scenario

Purpose: The purpose of this study was to describe a novel suture pull-through technique of EndoArt implant insertion. Method: EndoArt insertion was performed using a novel suture pull-through technique after several failed Descemet membrane endothelial keratoplasty surgeries for a 59-year-old woman who had undergone multiple surgeries after open globe injury and had artificial iris implant with scleral-fixated intraocular lens. Result: With this technique, EndoArt insertion into the anterior chamber was possible without implant dislocation. Postoperatively, anterior segment optical coherence tomography was recorded and peripheral detachment of the implant was noted. Rebubbling was required thrice with augmentation of the anchoring sutures. At 45 days of follow-up, EndoArt was principally attached. Conclusions: A novel suture pull-through technique of EndoArt implant insertion can be used for ensuring higher safety in complex cases like aphakia, aniridia, and vitrectomized eyes to prevent implant dislocation into the vitreous cavity.