A Novel Technique for scleral fixation of Carlevale Intraocular Lens without conjunctival opening utilizing Hoffman Pockets

Purpose: The aim of this study was to report a novel surgical technique for scleral fixation of Carlevale intraocular lens (IOL) without conjunctival dissection using Hoffman pockets. Methods: An 80-year-old woman with IOL dislocation in her right eye required IOL exchange. After removing the dislocated IOL, a Carlevale IOL was implanted, securing the self-blocking harpoons within scleral pockets which were constructed using Hoffman technique. Results: Surgical procedure was uneventful. During the next 3-month follow-up, Carlevale IOL remained stable within the scleral pockets, and no signs of IOL dislocation or decentration were observed. Visual acuity significantly improved from 20/200 preoperatively up to 20/32 postoperatively due to corneal scaring from previous herpetic keratitis. No postoperative complications were recorded. Conclusion: Creating scleral pockets without conjunctival dissection using Hoffman pockets technique represents a reliable and effective method for achieving both secure fixation and effective scleral covering of Carlevale IOL haptics. The absence of conjunctival opening, apart from patient postoperative comfort, reduces risk of postoperative complications, including conjunctival erosion and infection. The presented technique offers a promising alternative for Carlevale IOL scleral fixation.