Causes of tilt in the posterior chamber lens around the axis of the suture following its attachment to the sclera

PURPOSE: The aim of the study is to find out how the way of tying the suture around the haptics creates the tilt of the lens around the axis of the suture. MATERIAL AND METHODS: The study was carried out using a transparent polyethylene cylinder 30 cm long 12 mm in diameter similar to the one of the eyeball in the area of sulcus ciliaris. The lenses were sutured about 5 mm from one of the ends of the cylinder using 9-0 suture. The deviation of the lens was evaluated be measuring the distance of the circumference of the haptic from the edge of the cylinder. The study was carried out using lenses without fixation holes in loops with the holes in one loop and holes in both loops. Various ways of tying the suture in the holes of the haptic were applied. RESULTS: The lenses without holes in loops were tilting around the axis of the suture. Stabilisation of these lenses was received after using two sutures on one of the loops. Similarly, lenses with hole in one loop were not tilting just after using two sutures in loop without hole. The lenses with two holes in loops were not tilting when fixation sutures were tying in a way which balances the tilt forces of sutures on each loop. CONCLUSIONS: A kind of tying the suture around the haptic has significant importance on tilt of the lens around the axis of the suture. In case of necessity to suture lenses without holes in the haptics three or four sutures (two or one on each haptic) should be applied and they must be pierced in the sclera at the distance of 5 mm from each other. Lenses with hole on one loop should have two fixation sutures on loop without hole. Lenses with holes in two loops should have sutures tying in a way which balances the tilt forces of sutures on each loop.