Four-point Scleral Fixation using the Single-loop Suture Technique for Posterior Chamber Intraocular Lens Implantation: Long-Term Follow-up Results

Purpose: To investigate results of the single-loop suture scleral fixation technique with long-term follow-up.Methods: This retrospective study analyzed patients who underwent scleral fixation using the single-loop suture technique between January 2010 and June 2024 with a minimum follow-up period of one year.Ophthalmic outcomes and complications including polypropylene suture type and re-operation rates were evaluated.Results: A total of 215 eyes in 201 patients were included.Polypropylene suture types used included 10-0 in 52.1% (112 of 215), 9-0 in 44.2% (95 of 215), and 3.7% (8 of 215) remained unconfirmed.The re-operation rate was 22.3% (25 of 112) with 10-0 polypropylene, 1.1% (1 of 95) with 9-0 polypropylene, and 12.1% (26 of 215) in total.Intraocular lens repositioning was needed in 0.9% (2 of 215).Postoperative intraocular pressure (IOP) elevation occurred in 51.6% (83 of 161) of patients without baseline glaucoma history; 94.0% (78 of 83) of cases were well controlled with glaucoma medication and 44.6% (37 of 83) were able to discontinue it.Conclusions: Single-loop suture scleral fixation is a safe and effective surgical technique with a low incidence of serious complications.This technique leads to stable lens centering with a low rate of lens repositioning.Polypropylene suture type can affect the re-operation rate.Close monitoring of IOP is recommended.