Modified technique for trocar-based sutureless scleral fixation of intraocular lenses: A new approach to haptic externalization

PURPOSE: To describe a modified technique of haptic externalization for trocar-based sutureless scleral fixation of intraocular lenses, in order to avoid working with forceps in the iris plane in a manner that may be unfamiliar to the vitreoretinal surgeon. METHODS: This prospective, interventional case series included four eyes of four patients with dislocated intraocular lens (IOL). The modified haptic externalization technique avoids the pitfalls of iris-plane maneuvers by intentionally dropping the IOL onto the retina and using the forceps to grasp the tips of the haptics prior to direct externalization from the same grab. RESULTS: Four patients underwent scleral fixation of IOL using modified haptic externalization technique. One patient was lost to follow up after postoperative day 1. At the last follow up, all eyes demonstrated stability and good centration of scleral fixated IOL. All three patients achieved a best corrected visual acuity same or better compared to before the operation. One patient developed vitreous hemorrhage which later spontaneously resolved. CONCLUSIONS: The modified haptic externalization technique is a simple and quick modification using maneuvers familiar to vitreoretinal surgeons. It has demonstrated safety among a small pilot group of patients.