Single-Needle-Guided Haptic Locking Of Intraocular Lens With Haptic Flange For Intra-Scleral Fixation

Published 2025 - 43rd Congress of the ESCRS

Reference: FP12.04 | Type: Free paper | DOI: 10.82333/5fea-8r94

Authors: Tatiana Soriano ¹ , Elena Arrondo ² , Natalino Guiuliano ² , Maribel Acuña ² , Sofia Bielsa Alonso* ² , Laura Gonzalez ² , Ana Nolla ² , Sandra Suescun ² , Mar García ² , Ruth Sintes ² , Alvaro Terroba ² , Jose Luis Güell ²

¹IMO Barcelona,Barcelona,Spain;Hospital México-CCSS, Hospital CIMA,San Jose,Costa Rica, ²IMO Barcelona,Barcelona,Spain

Purpose

To describe a technique for single-needle-guided haptic locking of an intraocular lens (IOL) with a haptic flange for intra-scleral fixation.

Setting

Retrospective, interventional, noncomparative, case series
Participants: Patients with an absence of capsular support, including those with aphakia, a subluxated/dislocated crystalline lens, and a dislocated IOL, were included in this study.

Methods

Procedure: A modified haptic flange technique for intra-scleral IOL fixation uses a 26G needle with a silicone stopper. The needle docks the stopper to the IOL’s leading haptic; external adjustment of the stopper fine-tunes the optic and trailing haptic positions. The haptic end is cauterized to form a flange, which is retracted and fixed into scleral tunnels.
Outcomes: Measured parameters include preop/postop visual acuity (VA), surgery time, refractive error, IOL tilt/decentration (5.14°/0.35mm), and complications (intraop: 3.17% hemorrhage; early postop: 7.94% edema, 3.17% hypotony/IOP↑/iris capture/vitreous hemorrhage/macular edema; late postop: 3.17% flange exposure, 1.67% retinal detachment).

Results

The study included 63 cases (63 eyes) with a mean age of 62.5 years. Mean surgical time was 12.23 minutes. Postoperative uncorrected distance visual acuity (UDVA) improved significantly to 0.13 logMAR at 3 months (P < 0.05). Mean postoperative spherical equivalent was -0.72 D. IOL tilt and decentration averaged 5.14° and 0.35 mm, respectively. Intraoperative complications included anterior chamber angle hemorrhage (3.17%). Early postoperative complications (within 3 months) included corneal edema (7.94%), hypotony (3.17%), IOP elevation (9.52%), iris-optic capture (3.17%), vitreous hemorrhage (4.76%), and macular edema (4.76%). Late complications (beyond 3 months) included flange exposure (3.17%) and retinal detachment (1.67%).

Conclusions

Single-needle-guided haptic locking of an intraocular lens with a haptic flange for intra-scleral fixation is easy to perform, minimally invasive, and provides firm haptic fixation.