Modified Scleral Fixation for Intraocular Lenses With Unloopable Haptic Designs

Purpose: To present a novel technique for rescuing a dislocated intraocular lens with a haptic design that would otherwise typically require intraocular lens exchange owing to non-tapered, non-fenestrated haptics. Methods: Three consecutive cases underwent an intraocular lens rescue technique involving haptic piercing and a “handshake” maneuver to achieve scleral fixation. Results: All intraocular lenses were successfully repositioned, with postoperative visual recovery to 20/25 or better in all cases. No intraoperative or postoperative complications were encountered. Conclusions: Modification of previously reported scleral suture techniques allows repositioning of intraocular lens designs with haptics that either lack holes or are not amenable to standard haptic-looping methods, thereby allowing rapid and effective management of intraocular lens dislocation. These cases would otherwise require intraocular lens exchange. This technique offers an alternative surgical approach that might be preferable, especially for eyes with other constraints such as prior glaucoma or corneal interventions.