Short-Term Results of New Surgical Technique for Intrascleral Fixation Using Catheter Needles: Lock and Lead Technique
Narrative Responses:
Purpose
To evaluate a new surgical technique for intrascleral fixation of standard 3-piece posterior intraocular lens (IOL) without capsular support using catheter needles instead of expensive forceps.
Methods
A bent catheter needle was used to penetrate through the surgical wound from the sclerotomy. The haptic is locked by a catheter needle between external tube and internal needle, and leaded through scleral incision. The haptics were inserted and buried into the scleral tunnels assisted with 30G guiding needles.
25 eyes of 24 patients were included. Informed consent was obtained. The operation was performed in conformity with the Declaration of Helsinki and was approved by our ethical committee.
Results
With this method, most of intraocular manipulation can be avoided. In all cases, the surgery was performed without assistant’s holding haptics. 30G needles can guide the haptics into long narrow scleral tunnels. Surgical time was 19 min in average from the beginning of scleral incision to the end of the surgery. IOL astigmatism was better than that of suturing IOL. Following complications were observed in this short term observation: A case of endothelial damage, 4 cases of self-limiting vitreous hemorrhage, 3 cases of ocular hypertension, and a case of hypotension.
Conclusion
This new method was easy, safe, and did not require special devices compared to the current common methods. Long narrow intrascleral tunnels were expected to minimize IOL dislocation. We named this new technique as lock and lead technique.