Minimally invasive relocation of subluxated single piece AcrySof intraocular lens

We describe an ab externo technique for scleral fixation of a subluxated single piece AcrySof (Alcon, Texas, USA) intraocular lens (IOL). A 10-0 polypropylene transcleral suture brought out of a paracentesis and traced back to form a loop is used to tie a cow hitch knot around a temporarily externalised haptic. The one piece design of the IOL, with flexible haptics, allows temporary externalisation through a 1.2 mm paracentesis. The tacky nature of the haptic material, square edges and the knob at the tip prevent slippage of the knot. The advantage of this technique is that the same one piece AcrySof IOL is retained and secured, while the risks and manipulations associated with explantation and exchange are avoided. While mere sulcus placement of a single piece AcrySof IOL may be associated with complications, scleral fixation is a viable solution.