Literature DB >> 28820166

Commentary: Comprehending haptic exteriorization in intrascleral haptic fixation of an intraocular lens.

Priya Narang1.   

Abstract

Entities:  

Year:  2017        PMID: 28820166      PMCID: PMC5598191          DOI: 10.4103/ijo.IJO_489_17

Source DB:  PubMed          Journal:  Indian J Ophthalmol        ISSN: 0301-4738            Impact factor:   1.848


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Since Gabor and Pavlidis[1] introduced the concept of intrascleral fixation of an intraocular lens (IOL), various techniques have been described in peer literature for the same. Glue-assisted intrascleral haptic fixation (glued IOL)[2] is one of the most popularized technique that has been further modified in its application and maneuverability.[34] Handshake technique[56] comprises the most essential component of performing the glued fixation as it facilitates haptic exteriorization by allowing the surgeon to assess the tip of the haptics for its safe withdrawal from the sclerotomy sites without creating a kink or a break in the externalized haptic. Threading the haptics into the needle for facilitating exteriorization have been recently made quite popular with flanged haptic exteriorization technique.[7] The extraocular needle-guided haptic insertion technique (X-NIT) also comprises of threading the haptic into the 26-gauge needle and then placing a silicon stopper to prevent the haptic from slipping inside the eye. To prevent the haptic slippage, silicon tires of iris hooks have been used previously by Beiko and Steinert[4] in glued IOL surgery whereas Safran uses the small transversely cut pieces of intravenous tubing sets to thread the haptics. In X-NIT technique, a 26-gauge needle is passed from the scleral site about 1.5 mm behind the limbus and the needle is extruded from the sclerocorneal wound. A probable distortion of the globe may occur by this maneuver as the wound is large, and the IOL haptic is threaded through this wound into the 26-gauge needle. A special mention is necessary to address the issue of threading the trailing haptic into the barrel of the needle, especially when the leading haptic has been externalized. To ease this, Yamane et al.[8] recommends not to externalize the leading haptic before the trailing haptic has been threaded into the lumen of the needle. This prevents counterclockwise rotation of the IOL, and the distance between the trailing haptic and the needle lumen is minimized facilitating threading of the trailing haptic.[7] Nevertheless, it is essential to state that whichever technique the surgeon adopts it is very important that utmost care and precaution is taken, and the nuances of the surgical procedure are well understood and taken care of to optimize the visual outcome.
  8 in total

1.  Sutureless intrascleral posterior chamber intraocular lens fixation.

Authors:  Scharioth G B Gabor; Mitrofanis M Pavlidis
Journal:  J Cataract Refract Surg       Date:  2007-11       Impact factor: 3.351

2.  Fibrin glue-assisted sutureless posterior chamber intraocular lens implantation in eyes with deficient posterior capsules.

Authors:  Amar Agarwal; Dhivya Ashok Kumar; Soosan Jacob; Chandresh Baid; Athiya Agarwal; Sridhar Srinivasan
Journal:  J Cataract Refract Surg       Date:  2008-09       Impact factor: 3.351

3.  Modified method of haptic externalization of posterior chamber intraocular lens in fibrin glue-assisted intrascleral fixation: no-assistant technique.

Authors:  Priya Narang
Journal:  J Cataract Refract Surg       Date:  2013-01       Impact factor: 3.351

4.  Modification of externalized haptic support of glued intraocular lens technique.

Authors:  George Beiko; Roger Steinert
Journal:  J Cataract Refract Surg       Date:  2013-03       Impact factor: 3.351

5.  Handshake technique for glued intrascleral haptic fixation of a posterior chamber intraocular lens.

Authors:  Amar Agarwal; Soosan Jacob; Dhivya Ashok Kumar; Ashvin Agarwal; Smita Narasimhan; Athiya Agarwal
Journal:  J Cataract Refract Surg       Date:  2013-03       Impact factor: 3.351

6.  Flanged Intrascleral Intraocular Lens Fixation with Double-Needle Technique.

Authors:  Shin Yamane; Shimpei Sato; Maiko Maruyama-Inoue; Kazuaki Kadonosono
Journal:  Ophthalmology       Date:  2017-04-27       Impact factor: 12.079

7.  Sutureless 27-gauge needle-guided intrascleral intraocular lens implantation with lamellar scleral dissection.

Authors:  Shin Yamane; Maiko Inoue; Akira Arakawa; Kazuaki Kadonosono
Journal:  Ophthalmology       Date:  2013-10-20       Impact factor: 12.079

8.  The "correct shake" for "handshake" in glued intrascleral fixation of intraocular lens.

Authors:  Priya Narang; Amar Agarwal
Journal:  Indian J Ophthalmol       Date:  2016-11       Impact factor: 1.848

  8 in total

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