Scleral loop to fixate an encircling band

The standard fixation of an encircling belt is a permanent scleral suture. Sutures have the disadvantage that they eventually may protrude through the conjunctiva, they may cut through the sclera causing dislocation of the belt, or they may be assciated with infections.

The scleral loop requires only a round knife (Teller-Messer), formed like a plate. In case of very thin (blue) sclera a suture will not hold and extra sclera need to be sutured onto the eye. However in case of a scleral loop the sclera is prepared down to the choroid leaving usually a suffient strong scleral loop to hold the band. To avoid the tip of the band to perforate the choroid when sliding behind the sclera a guide is introduced first and removed after the band is in place.