In cases of insufficient zonular support, using a flange technique has become popular after Dr Shin Yamane shared his technique a few years ago. There are other options besides creating the flange on the haptic itself: 6-0 prolene suture can be used in order to create additional support for good long-term stability and centration of the IOL.
In this video, Dr. Ori Mahler from Israel shows us three different cases where there is a single flange support, a double flange support, or even four flanges for supporting a dislocated IOL. The single flange using the 6-0 prolene to create an eyelet was described by Dr. Masayuki Akimoto from Osaka, Japan. I was recently in Osaka (and Kyoto) and I was impressed by the surgical efficiency and innovation by these Japanese ophthalmologists.
Click below to learn to master these IOL flange techniques:
Great video. One question. Won’t leaving the one piece IOL haptic in the sulcus cause iris rub and pigment dispersion? Like to hear your thoughts
thanks for the comment, Francis. Yes, you have a great point — it depends on where the haptic ends up. If it is in close proximity to the posterior iris, then yes it can cause issues. I have not personally tried the technique in question.
Sir,Could you please advice on followings?
1.How do you create an eyelet in a single piece IOL?
a.Is it with the curved needle used with 6/0 prolene?
b.Do i need to heat the needle?
2.What”s the low temperature cautery ?
Any special model you recommend?