Transconjunctival sutureless intrascleral fixation of 3-piece intraocular lenses using a curved needle

Abstract

Yamane technique revolutionized sutureless intrascleral fixation of intraocular lenses (IOLs).1 In this technique, a scleral tunnel is formed using a 27-gauge hypodermic needle, and IOL haptics are positioned inside the scleral tunnel by inserting the haptics inside the needle. We describe a new modification of Yamane technique with curved needles to overcome potential complications that arise due to the straight structure of the scleral tunnel in conventional Yamane technique. The distal part of a 27-gauge hypodermic needle is bent manually using a needle holder (designed to hold 5-0 or 6-0 sutures) to match the curvature of the limbus (Figure 1, a). The bevel of the needle is directed upward and slightly inward (Figure 1, b). The proximal part of the needle is further bent around 90 degrees for easier rotation of the instrument (Figure 1, c and d). The preparation steps of the curved needle are available in Video 1 (available at https://links.lww.com/JRS/A531).