{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:31:31Z","timestamp":1786649491444,"version":"build-2736575974"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","license":[{"start":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T00:00:00Z","timestamp":1751241600000},"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":[[2025,7]]},"abstract":"<jats:p>The occurrence of intraocular lens (IOL) implantation failure in phacoemulsification is relatively uncommon. However, because cataract surgery is the most prevalent surgical procedure worldwide, the aggregate instances of post-surgical aphakic status are significant. Though several alternatives, including anterior chamber IOL, iris-fixated IOL, and scleral-fixated IOL (SFIOL), exist for secondary IOL implantation, recent trends favor SFIOL implantation. In the realm of SFIOLs, all sutureless variants necessitate the exteriorization of the haptic through the sclera, implying a larger sclerotomy. Sutured SFIOL requires special lenses and typically involve rigid ones, which necessitate a larger incision. We describe a technique that involves utilizing a straight-needled 7-0 polypropylene suture for the 4-flanged intrascleral fixation of any foldable IOL that can be manually loaded onto a cartridge. This method combines the advantages of a reduced incision size and a smaller sclerotomy, addressing concerns associated with both sutureless and rigid SFIOL implantation.<\/jats:p>","DOI":"10.4103\/ijo.ijo_2888_24","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T07:00:34Z","timestamp":1751266834000},"page":"1072-1074","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Four-flanged, intrascleral fixation of foldable intraocular lens using straight-needled 7-0 polypropylene suture \u2013 A surgical technique"],"prefix":"10.4103","volume":"73","author":[{"given":"Vellam R","family":"Vivekanandan","sequence":"first","affiliation":[{"name":"Cataract and IOL Services, Aravind Eye Hospital, Pondicherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sivagami","family":"Nachiappan","sequence":"additional","affiliation":[{"name":"Department of Pediatric Ophthalmology, Aravind Eye Hospital, Pondicherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annamalai","family":"Odayappan","sequence":"additional","affiliation":[{"name":"Glaucoma Services, Aravind Eye Hospital, Pondicherry, India"},{"name":"Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naveen N","family":"Gangapatnam","sequence":"additional","affiliation":[{"name":"Cataract and IOL Services, Aravind Eye Hospital, Pondicherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merlin","family":"Benzy","sequence":"additional","affiliation":[{"name":"Cataract and IOL Services, Aravind Eye Hospital, Pondicherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rengaraj","family":"Venkatesh","sequence":"additional","affiliation":[{"name":"Glaucoma Services, Aravind Eye Hospital, Pondicherry, 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(X-NIT)","volume":"65","author":"Baskaran","year":"2017","journal-title":"Indian J Ophthalmol"},{"key":"R7-20260421","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1097\/ICO.0000000000002185","article-title":"Four-flanged intrascleral intraocular lens fixation technique: No flaps, no knots, no glue","volume":"39","author":"Canabrava","year":"2020","journal-title":"Cornea"},{"key":"R8-20260421","doi-asserted-by":"crossref","first-page":"2897","DOI":"10.4103\/IJO.IJO_2906_22","article-title":"4-Flanged intrascleral fixation of an intraocular lens through the dialing hole","volume":"71","author":"Vivekanandan","year":"2023","journal-title":"Indian J Ophthalmol"},{"key":"R9-20260421","doi-asserted-by":"crossref","first-page":"e00042","DOI":"10.1097\/j.jcro.0000000000000042","article-title":"Endophtalmitis associated with flange exposure after a 4-flanged canabrava fixation techique","volume":"9","author":"Roditi","year":"2020","journal-title":"JCRS Online Case Rep"},{"key":"R10-20260421","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1097\/j.jcrs.0000000000000310","article-title":"Scleral fixation of a 4-eyelet foldable intraocular lens in patients with aphakia using a 4-flanged technique","volume":"47","author":"Canabrava","year":"2021","journal-title":"J Cataract Refract Surg"}],"container-title":["Indian Journal of 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