Supplementary Material for: A Novel Rescue Surgical Technique For Stabilization Of Scleral-Fixated Intraocular Lens FIL SSF IOL (Carlevale Lens) – A Case Report

Introduction
The FIL SSF intraocular lens (IOL) (Carlevale, Soleko, Italy) is a sutureless scleral-fixated lens designed for cases of aphakia with insufficient capsular support. While generally stable, intraoperative complications such as haptic rupture may occur. We present a novel rescue technique for scleral fixation of FIL SSF IOL following rupture of the trans-scleral plug during combined penetrating keratoplasty (PKP), three-port pars plana vitrectomy (3p-PPV), and IOL implantation.

Case Presentation
During the combined procedure, rupture of one FIL SSF IOL plug was identified. The compromised haptic was externalized into the subconjunctival space. The sclerotomy was sutured to secure the haptic, achieving both immobilization and stable positioning of the IOL. Postoperatively, the patient was followed for six months. Best corrected visual acuity (BCVA) reached 0.2 (decimal scale), intraocular pressure was stable at 14 mmHg in the left eye, the corneal graft remained clear, and the FIL SSF IOL maintained centration without further complications.

Conclusion
This case demonstrates that intraoperative rupture of the FIL SSF IOL haptic can be effectively managed using a scleral anchoring technique. This approach provides a stable and safe alternative for salvaging IOL fixation during complex anterior and posterior segment surgeries.