Z-suture - A new knotless technique for transscleral suture fixation of intraocular implants

Peter Szurman (1) , Katrin Petermeier (1) , Sabine Aisenbrey (1) , Martin S Spitzer (1) , Gesine B Jaissle (1)

1 Centre of Ophthalmology, University Eye Hospital T�bingen

The presented Z-suture is a simple, rapid and safe knotless technique that facilitates transscleral suture fixation of various intraocular implants in the ciliary sulcus like sutured intraocular lenses, artificial iris prostheses, and iris diaphragms. As the knotless approach reliably avoids suture erosion, external fixation can be performed without any protecting scleral flaps or lamellar grooves. The needle is simply passed through the sulcus, and the emerging polypropylene suture is secured in the sclera using a zigzag shaped intrascleral suture (Z-suture). Each pass starts directly adjacent to the exiting site. Five passes are sufficient to reliably fix the suture resisting even maximum tractive forces. Once this procedure is done, the suture can be cut without any knot. By avoiding suture knots, and hence the necessity for intrascleral flaps, this knotless approach may help to reduce suture-related complications such as scleral atrophy, suture erosion and infections.

Mots clés: Sclera and Episclera; Posterior Chamber; Lens and zonules; Treatment Surgery; Prosthesis

Peter Szurman, Katrin Petermeier, Sabine Aisenbrey, Martin S Spitzer, Gesine B Jaissle. Z-suture - A new knotless technique for transscleral suture fixation of intraocular implants. British Journal of Ophthalmology, 2010, 94 (2), pp.167. ⟨10.1136/bjo.2009.162180⟩. ⟨hal-00509050⟩