A Novel Custom Bent 27-Gauge Needle-Guided Suture Snare Technique for Scleral Fixation of Posterior Chamber Intraocular Lenses

Purpose:To describe a custom bent 27-gauge needle-guided suture snare technique for scleral fixation of posterior chamber intraocular lenses (PCIOL).Methods:An 8-0 polypropylene suture was threaded into the lumen of a custom bent 27-gauge needle, and the needle tip was advanced into the eye from the intraocular lens (IOL) fixation point. The suture was threaded through the posterior limbal incision inside the IOL haptic loop and pulled out. The needle tip was advanced into the eye again, going around the IOL haptic loop through the same limbal incision. The suture was threaded in again, and the needle was withdrawn from the eye, completing fixation of the IOL haptic loop. The suture knot was buried in the stroma of the sclera.Results:The technique was performed in 10 eyes of 10 patients, with a preoperative logarithm of the minimum resolution angle-corrected visual acuity of 0.73 +/- 0.55 (Snellen 20/107), improvement of 0.24 +/- 0.27 (Snellen 20/35) at the final follow-up visit, and a mean postoperative PCIOL tilt of 2.78 +/- 1.32 degrees. There were no cases of pupillary capture or suture-related complications during follow-up.Conclusion:The curved needle-guided suture snare technique provides a simple minimally invasive method of scleral suture fixation of PCIOL.