Facilitated Trailing Haptic Externalization Technique For Intrascleral Intraocular Lens Fixation
Published 2022 - 40th Congress of the ESCRS
Reference: FPM01.08 | Type: Free paper | DOI: 10.82333/7zkm-gv19
Authors: Fikret Ucar* 1 , Servet Cetinkaya 1
1Ophthalmology,Konyagoz Eye Hospital,Konya,Türkiye
Purpose
The externalization of the trailing haptic is the most difficult step of the Yamane technique. We wish to present a new technique to simplify surgery and facilitate the externalization of the trailing haptic.
Setting
Konyagoz Eye Hospital, Department of Ophthalmology, Konya, Turkey.
Methods
Unlike the original technique of Yamane, first the direction of the 4-5 mm tip of the trailing haptic is straightened with the help of forceps. After the second needle enters the posterior chamber in the same manner, the edge of the intraocular lens (IOL) optic is pushed towards the opposite scleral tunnel with the needle. Thus, it is possible to reach the trailing haptic more easily with the intraocular forceps and to engage the tip of the haptic at a more appropriate position. Additionally, the trailing haptic approaching the center from the periphery and the straightened distal part of the haptic towards the direction of the needle can facilitate insertion of the trailing haptic into the lumen with a one-time use of forceps.
Results
This technique was performed in 73 eyes of 68 patients and the mean patient age at the time of surgery was 55.6 ± 14.5 years (range, 22-78 years). There were 36 (52.9%) men and 32 (47.0%) women. During surgery, no intraoperative complications such as endothelial touch, vitreous loss, iris or ciliary body damage, or hyphema were encountered. The mean operation duration was 15.0 ± 2.4 minutes (range, 11-20 minutes). The mean postoperative follow-up time was 11.7 ± 5.6 months (range, 6-36 months). During the postoperative follow-up period, no patient developed haptic exposure, IOL dislocation, iris capture, postoperative hypotony, vitreous hemorrhage, choroidal effusion, cystoid macular edema, or retinal detachment.
Conclusions
Yamane technique is superior to previous methods as it is faster, less complicated and less traumatic. On the other hand, the externalization of the trailing haptic in intrascleral fixation is the most difficult step and remains a serious concern for surgeons. Once the trailing haptic is pushed into the anterior chamber, it may locate in the iridocorneal angle or penetrate the iris. This procedure becomes even more difficult and complicated especially in eyes with iris damage, narrow anterior chambers, or corneal scarring. In this technique, the trailing haptic approaching the center from the periphery and the straightened distal part of the haptic towards the direction of the needle can facilitate the externalization of the second haptic.