Alternative technique for implantation of a scleral-fixated intraocular lens.

We describe an alternative method of implanting a scleral-fixated intraocular lens (IOL) that facilitates passage of the suture and improves control of suture placement. An ab externo approach introduces a loop of polypropylene (Prolene) through the sclera in a single 27-gauge puncture. The loop is used to secure the IOL haptic in a cow-hitch fashion, which minimizes the risk for the knot to unravel and the IOL to dislocate. After the IOL is placed in the eye, it is secured with the externalized curved suture needle. Knots are covered with a scleral flap. This technique improves efficiency and control in placing an IOL near the normal anatomical location of the crystalline lens when the absence of capsule support precludes nontethered placement of an IOL in the sulcus or capsular bag.