Chang Siepser IOL Fixation

Here is a video from tom oetting at the university of iowa showing how to fix a 3 piece IOL to the iris.

David chang described the use of a siepser sliding knot to secure an IOL to the iris as shown here. The sipser sliding knot is very useful technique that can be used to secure an IOL to the iris or sclera, can be used for iris repair, and can be used to secure an Ahmed segment.

Here is the reference for david chang's paper:

Chang DF, Siepser slipknot for McCannel iris-suture fixation of subluxated intraocular lenses. J Cataract Refract Surg. 2004 Jun;30(6):1170-6.

Thanks for any comments. tom o

Category:

Education

Tags:

• iol fixation
• cataract surgery
• IOL surgery
• eye surgery
• subluxed iol
• siepser slip knot

[oettingt]

The standard way to place an IOL for iris fixation with suture is to use an old fashioned IOL forceps in the moustache configuration. Then when you release the IOL the haptic are placed posterior and the optic anterior to an undiluted or partially dilated pupil. See Walter starks jars paper with nice drawings on this topic. Thx for your comment

[ahdootm]

Hi. My question is in an aphakic patient who is undergoing secondary IOL placement, how do you initially insert the IOL to capture the optic and place the haptics in the sulcus without placing the entire lens in the sulcus first and then pulling up the optic? I fear placing the lens in the sulcus primarily would risk a posterior dislocation in a long standing aphakic patient who lacks proper support to hold a 3 piece IOL in the sulcus temporarily before pulling the optic up to the AC. Thanks.