We describe a modified method for scleral fixation of posterior chamber intraocular lenses (IOLs). A double-armed, 10-0 polypropylene (Prolene) suture on a curved long needle is passed through a groove in the sclera and retrieved within the barrel of a bent 25-gauge needle through the opposite groove. Double transscleral passages enable 4-point fixation and provide better stability and centration. Knots are buried completely in the scleral groove. In a series of 10 cases, the IOLs were well centered, no sutures protruded from the scleral groove, and the vision in all eyes improved. In 1 case, a ciliary hemorrhage occurred during insertion of the 25-gauge needle, but the bleeding stopped after ocular pressure reform. This technique is easy to perform, improves centration and stability of the IOL, and avoids suture exposure.
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Lin et al. (2004) studied this question.
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