Bimanual Placement Of Footplates Of Phakic Intra-Ocular Lens (Implantable Collamer Lens,Evo Icl) In Eyes With Intra-Operative Miosis

To describe and assess the efficiency of a novel technique of placing footplates of ICL in sulcus in poorly dilated or intraoperative constricted pupil utilizing peri-optic holes and two instruments simultaneously (Sinskey hook and ICL manipulator).

Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences,New Delhi

In this study, 12 eyes of 10 patients underwent ICL implantation through this novel technique. The technique employs a bimanual approach of tucking the footplates of ICL in sulcus in eyes with intra-operative miosis utilising peri-optic holes using sinskey IOL hooks and ICL manipulator bimanually. The ICL peri-optic hole is engaged with the sinskey hook by one hand to push ICL slightly backwards and facilitate the sliding of the footplate by ICL manipulator by another. The procedure is repeated on either side until the ICL is tucked in the sulcus. This method can also be useful for newer surgeons who encounter difficult ICL placement. However, too small a pupil is a limiting factor; this technique can be of use up to mid dilated pupil;

All patients had uneventful surgery. At 1 week follow-up, the post-operative best corrected visual acuity of all patients was 20/20. Mean intraocular pressure was 15±2 mmHg. Complications rarely occurred and were not significant.

Bimanual placement of haptics of ICL may represent safe and effective technique in intraoperative pupillary miosis.