{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T10:56:27Z","timestamp":1793271387404,"version":"4.5.0"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T00:00:00Z","timestamp":1740528000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>This study aimed to compare the 1-year clinical outcomes of three scleral fixation techniques for intraocular lens (IOL) implantation: ab externo scleral fixation, trocar-cannula-based sutureless fixation (\u201csutureless fixation\u201d), and four-point scleral fixation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This retrospective study evaluated 77 consecutive eyes treated with scleral fixation of the IOL. The ab externo method utilized conventional sutured techniques, while the trocar-cannula-based sutureless method was adapted from the \u201cYamane\u201d technique, employing a wide-angle fundus lens to facilitate IOL manipulation in the vitreous cavity. The four-point fixation method involved a double-armed polypropylene suture and two 26-gauge needles to secure the four IOL haptics at four distinct sites. One-way analysis of variance (ANOVA) was used for statistical comparison between the groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The four-point fixation group exhibited superior best-corrected visual acuity compared to the sutureless and ab externo groups at 1 and 3 months postoperatively (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.004 and\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.002, respectively), along with significantly less surgically induced astigmatism (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). The sutureless group had the shortest operative time, while the ab externo group had the longest (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). No instances of IOL iris capture occurred in the four-point group, while three cases (10.0%) were noted in the sutureless group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The four-point fixation technique provides significant benefits, including faster visual recovery, enhanced IOL stability, and lower surgically induced astigmatism (SIA) values. The sutureless technique provides the benefit of shorter operative times but does pose a risk of IOL capture in a limited number of cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijo.ijo_1840_24","type":"journal-article","created":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T03:03:49Z","timestamp":1740539029000},"page":"422-428","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Comparison of three types of scleral fixation of the intraocular lens"],"prefix":"10.4103","volume":"73","author":[{"given":"Zeeyoon","family":"Byun","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sungsoon","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingui","family":"Kong","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,2,26]]},"reference":[{"key":"R1-20260422","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1007\/BF00159844","article-title":"Lens guide suture for transport and fixation in secondary IOL implantation after intracapsular extraction","volume":"9","author":"Malbran","year":"1986","journal-title":"Int Ophthalmol"},{"key":"R2-20260422","doi-asserted-by":"crossref","first-page":"1421","DOI":"10.1016\/j.jcrs.2018.08.008","article-title":"New use of 8-0 polypropylene suture for four-point scleral fixation of secondary intraocular lenses","volume":"44","author":"John","year":"2018","journal-title":"J Cataract Refract Surg"},{"key":"R3-20260422","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1111\/aos.14307","article-title":"Sutureless intrascleral fixation using different three-piece posterior chamber intraocular lenses: A literature review of surgical techniques in cases of insufficient capsular support and a retrospective multicentre study","volume":"98","author":"Czajka","year":"2020","journal-title":"Acta Ophthalmol"},{"key":"R4-20260422","doi-asserted-by":"crossref","first-page":"e499","DOI":"10.1111\/aos.14313","article-title":"Flanged intraocular lens fixation via 27-gauge trocars using a double-needle technique decreases surgical wounds without losing its therapeutic effect","volume":"98","author":"Ishikawa","year":"2020","journal-title":"Acta Ophthalmol"},{"key":"R5-20260422","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1080\/08820538.2019.1652761","article-title":"Outcomes of using sutureless, scleral-fixated posterior chamber intraocular 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