A Modified Flanged Intrascleral Intraocular Lens Fixation Technique Using an Externalized Needle for Haptic Docking

Abstract

The Yamane intrascleral flanged haptic fixation technique has obviated the need for resources such as suture or glue. However, intraocular maneuvers to properly dock haptics into the needles for externalization can be difficult for even adept eye surgeons and is especially difficult when visualization through the cornea is poor. Additionally, one traditional resource, intraocular forceps, has been critical in both the original technique and proposed modifications since its inception. We describe a modified flanged intrascleral intraocular lens fixation technique by docking the second haptic externally at the main corneal incision. This technique does not require the use of microforceps, which is advantageous to surgeons who lack access to specialized instrumentation. Additionally, this technique may provide added safety, visibility, and ease for surgeons by docking the haptic externally at the corneal incision rather than within the eye.

Flapless and Sutureless Intrascleral Fixation of Posterior Chamber Intraocular Lens for Correction of Aphakia in Absence Of Capsular Support

“…In this study, we assessed safety and efficacy of one of modifications of Yamane technique. The modification includes direct threading of leading haptic into the lumen of 27 Gauge needle 11 , Externalization and intra fixation of leading haptic before manipulation with trailing haptic 12 and docking of trailing haptic externally through the main corneal incision 13 .…”

“…Ifantides et al, described docking of trailing haptic externally through corneal incision that allows docking of trailing haptic even when there is loss of corneal clarity or other media opacity within anterior segment. It minimizes damage to intraocular structures, improves surgery speed and could potentially obviate the need for intraocular lens forceps 13 .…”

Size variability and fitting of 30-gauge thin-wall needles and 3-piece intraocular lens haptics for the flanged intrascleral fixation technique

“…[1][2][3][4] Some modifications of the original approach have been described. [5][6][7] The essential steps of the technique are the formation of a precise needle-made trans-scleral tunnel, haptic-to-needle docking, haptic externalization, and haptic flanging with heat. To attain optimal positioning and stability of the IOL, the scleral tunnel should be tight and the flange should wedge into the tunnel entry.…”

Novel A-type scleral suture technique for sulcus-fixated intraocular lens tilt

“…Therefore, Yamane technique has recently gained popularity, and many modifications have been developed. 13–15 However, it also has disadvantages, such as the possibility of IOL tilt and scleral perforation if the scleral tunnel is asymmetrical. 16,17…”

“…Therefore, Yamane technique has recently gained popularity, and many modifications have been developed. [13][14][15] However, it also has disadvantages, such as the possibility of IOL tilt and scleral perforation if the scleral tunnel is asymmetrical. 16,17 The corneal endothelial cell density, which is essential to maintain corneal transparency, significantly decreases with repeated intraocular surgeries.…”