Scleral Fixation of a Dislocated Toric Intraocular Lens Using a Four-Point Flanged Technique

Abstract

Purpose: To report a modified four-point flanged intrascleral fixation technique using an existing plate-haptic toric multifocal intraocular lens (IOL) without eyelets in a case of IOL dislocation.Case summary: A 56-year-old male presented with dislocation of a previously implanted toric multifocal IOL (Lentis Mplus Toric) without eyelets. Instead of performing an IOL exchange, a modified Canabrava technique was employed, utilizing four-point fixation with 6-0 polypropylene sutures and creating flanges at each fixation site. Postoperatively, the IOL remained well-centered and maintained alignment with its original axis (90°) for 12 months. Both distance and near visual acuity were well preserved throughout the follow-up period.Conclusions: Plate-haptic toric multifocal IOL without eyelets can be successfully stabilized using a modified four-point flanged fixation technique. Sustained axis alignment and favorable visual outcomes suggest that this approach may have clinical utility in carefully selected cases.