Sliding internal knot technique for late in-the-bag intraocular lens decentration

We describe a technique that uses a sliding (Siepser) internal knot to secure the intraocular lens (IOL) and capsular bag complex to the sclera. The technique is helpful in cases of late dislocation of the IOL-capsular bag complex, which seems to be particularly common in patients with pseudoexfoliation. The technique, which borrows from earlier techniques, has the advantages of an external approach of the suture needle and a sliding knot with an internal tie that does not require a knot to be covered or rotated.