Needle-Assisted Scleral Fixation Suture Technique for Relocating Posteriorly Dislocated IOLs

Authors:
  • WSWilliam E. Smiddy
    William E. Smiddy
  • HFHarry W. Flynn
    Harry W. Flynn
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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.1Exteriorizing the IOL haptic to allow suture placement involves blindly dragging the haptic through the vitreous base, risking peripheral retinal damage.2We describe and illustrate below a minor modification in technique, using a needle developed for iris fixation.3This 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

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