Needle-assisted scleral fixation suture technique for relocating posteriorly dislocated IOLs.

Abstract

To the Editor. —Several recent reports on repositioning posteriorly dislocated intraocular lenses (IOLs) have described a variety of techniques for transscleral suture fixation of the IOL haptics. Refinements have been directed toward the most challenging aspect of such techniques: fixing the suture to the haptic. Suturing techniques requiring intraocular needle retrieval are awkward. Introducing a suture loop through a sclerotomy potentially impedes further surgical maneuvers through that sclerotomy, or requires extra sclerotomies. 1 Exteriorizing the IOL haptic to allow suture placement involves blindly dragging the haptic through the vitreous base, risking peripheral retinal damage. 2 We describe and illustrate below a minor modification in technique, using a needle developed for iris fixation. 3 This modification facilitates easy and precise scleral suture placement. Technique. —Partial-thickness scleral flaps are dissected at the meridian desired. Standard pars plana vitrectomy sclerotomies are prepared. A 9-0 or 10-0 polypropylene suture with a needle attached to