To compare the least required dislocation force (LRDF) among three scleral fixation techniques used for secondary intraocular lens (IOL) implantation. The flanged haptic technique (FFT) with a 3-piece IOL, the double-flange technique (DFT) and the Expanded Polytetrafluoroethylene suture fixation technique (GFT) with a four-loop haptics IOL. In this ex-vivo laboratory study, twenty human corneoscleral tissues (CSTs) were prepared, and all three fixation techniques were performed on each CST at standardized scleral positions. FFT was performed using a three-piece IOL with polyvinylidene fluoride (PVDF) haptics, whereas DFT and GFT were applied to a four-loop haptic IOL using either melted polypropylene flanges (DFT) or Expanded Polytetrafluoroethylene sutures (GFT). Mean LRDF differed significantly among techniques, with 0.73 ± 0.54 N (N) for DFT, 1.09 ± 0.48 N for FFT, and 3.95 ± 0.55 N for GFT. No significant difference was found between DFT and FFT ( p = 0.221). In contrast, GFT demonstrated significantly higher LRDF compared with both DFT ( p < 0.001) and FFT ( p = 0.042). Among the evaluated fixation methods, GFT provided the highest resistance to longitudinal dislocation forces in this ex-vivo model, while DFT and FFT demonstrated comparable biomechanical stability. These findings highlight substantial differences in mechanical resilience across fixation techniques.
Zeilinger et al. (Sat,) studied this question.