Clinical outcomes of repositioning subluxated in-the-bag intraocular lenses using the flanged belt-loop technique with 6-0 polypropylene

PURPOSE: To evaluate the clinical outcomes of scleral fixation using the flanged belt-loop technique in patients with in-the-bag intraocular lens (IOL) subluxation after cataract surgery. SETTING: Beyoglu Eye Training and Research Hospital, Turkey. DESIGN: Retrospective. METHODS: 23 eyes of 23 patients who underwent scleral fixation of subluxated in-the-bag IOLs using the flanged belt-loop technique, with a minimum follow-up of 6 months, were included. All surgeries were performed by a single experienced surgeon. The procedure involved transscleral fixation of the existing IOL using 6-0 polypropylene sutures with flanged ends, without conjunctival dissection or use of scleral flaps. Preoperative and postoperative data were collected, including corrected distance visual acuity (CDVA), intraocular pressure (IOP), corneal endothelial cell density (ECD), and central corneal thickness (CCT). RESULTS: The mean postoperative CDVA improved significantly ( P = .001). IOLs remained well-centered in 91.3% of eyes. Mild, asymptomatic decentration occurred in 2 eyes. There were no significant changes in IOP, ECD, or CCT ( P > .05). No major intraoperative or postoperative complications were reported. The surgical time was relatively short, and the technique caused minimal trauma to anterior segment structures. Bilateral haptic fixation was associated with better centration, especially after the initial learning curve. CONCLUSIONS: The flanged belt-loop technique is a safe and effective option for repositioning subluxated in-the-bag IOLs, avoiding the need for IOL explantation. Its minimally invasive nature, short operative time, and stable outcomes make it a favorable alternative. Larger studies with longer follow-up are necessary to validate these findings and compare efficacy with other fixation methods.