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Dogan L, Edhem Yilmaz I. Quaternary Knot Technique: Suture Knot Burial without Scleral Flap or Incision for Trans-scleral Fixation. JOVR [Internet]. 2023Jul.23 [cited 2024May4];18(3):342–347. Available from: https://knepublishing.com/index.php/JOVR/article/view/13784
https://doi.org/10.18502/jovr.v18i3.13784
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authors
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Levent Dogan
Levent Dogan
Tatvan State Hospital, Department of Ophthalmology, Bitlis, Turkey
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Ibrahim Edhem Yilmaz
Ibrahim Edhem Yilmaz
Kilis State Hospital, Department of Ophthalmology, Kilis, Turkey
Published Date
- Jul 23, 2023
Quaternary Knot Technique: Suture Knot Burial without Scleral Flap or Incision for Trans-scleral Fixation
Abstract
Despite the introduction of novel sutureless posterior chamber intraocular lens (IOL) fixation techniques, some conditions still require suture-assisted scleral fixation. If the scleral fixation suture knot is left directly under the conjunctiva, it may become exposed, resulting in an increased risk of endophthalmitis. To avoid this problem, we offer a new alternative, simple, and safe way for burying the end of the suture using knots in this report.
Keywords:
Conjunctival Erosion; Endophthalmitis; Knot Burial; Scleral Fixation
References
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2. Scharioth GB, Prasad S, Georgalas I, Tataru C, Pavlidis M. Intermediate results of sutureless intrascleral posterior chamber intraocular lens fixation. J Cataract Refract Surg 2010;36:254–259.
3. Yamane S, Inoue M, Arakawa A, Kadonosono K. Sutureless 27-gauge needle–guided intrascleral intraocular lens implantation with lamellar scleral dissection. Ophthalmology 2014;121:61–66.
4. De Silva SR, Arun K, Anandan M, Glover N, Patel CK, Rosen P. Iris-claw intraocular lenses to correct aphakia in the absence of capsule support. J Cataract Refract Surg 2011;37:1667–1672.
5. Rossi T, Iannetta D, Romano V, Carlevale C, Forlini M, Telani S, et al. A novel intraocular lens designed for sutureless scleral fixation: Surgical series. Graefes Arch Clin Exp Ophthalmol 2021;259:257–262.
6. Szurman P, Petermeier K, Aisenbrey S, Spitzer MS, Jaissle GB. Z-suture: A new knotless technique for transscleral suture fixation of intraocular implants. Br J Ophthalmol 2010;94:167.
7. Bucci FA Jr, Holland EJ, Lindstrom RL. Corneal autografts for external knots in transsclerally sutured posterior chamber lenses. Am J Ophthalmol 1991;112:353–354.
8. Bashshur Z, Ma’luf R, Najjar D, Noureddin B. Scleral fixation of posterior chamber intraocular lenses using fascia lata to cover the knots. Ophthalmic Surg Lasers 2002;33:445– 449.
9. Baykara M. Suture burial technique in scleral fixation. J Cataract Refract Surg 2004;30:957–959.
10. Oskala P. Friction knot to fixate scleral sutures. J Cataract Refract Surg 2015;41:497–500.
2. Scharioth GB, Prasad S, Georgalas I, Tataru C, Pavlidis M. Intermediate results of sutureless intrascleral posterior chamber intraocular lens fixation. J Cataract Refract Surg 2010;36:254–259.
3. Yamane S, Inoue M, Arakawa A, Kadonosono K. Sutureless 27-gauge needle–guided intrascleral intraocular lens implantation with lamellar scleral dissection. Ophthalmology 2014;121:61–66.
4. De Silva SR, Arun K, Anandan M, Glover N, Patel CK, Rosen P. Iris-claw intraocular lenses to correct aphakia in the absence of capsule support. J Cataract Refract Surg 2011;37:1667–1672.
5. Rossi T, Iannetta D, Romano V, Carlevale C, Forlini M, Telani S, et al. A novel intraocular lens designed for sutureless scleral fixation: Surgical series. Graefes Arch Clin Exp Ophthalmol 2021;259:257–262.
6. Szurman P, Petermeier K, Aisenbrey S, Spitzer MS, Jaissle GB. Z-suture: A new knotless technique for transscleral suture fixation of intraocular implants. Br J Ophthalmol 2010;94:167.
7. Bucci FA Jr, Holland EJ, Lindstrom RL. Corneal autografts for external knots in transsclerally sutured posterior chamber lenses. Am J Ophthalmol 1991;112:353–354.
8. Bashshur Z, Ma’luf R, Najjar D, Noureddin B. Scleral fixation of posterior chamber intraocular lenses using fascia lata to cover the knots. Ophthalmic Surg Lasers 2002;33:445– 449.
9. Baykara M. Suture burial technique in scleral fixation. J Cataract Refract Surg 2004;30:957–959.
10. Oskala P. Friction knot to fixate scleral sutures. J Cataract Refract Surg 2015;41:497–500.