Modified technique for intrascleral fixation of posterior chamber intraocular lens without scleral flaps

We present a modified technique for intrascleral fixation of a posterior chamber intraocular lens (IOL) without scleral flaps and assess its long-term safety and efficacy. The haptics of the IOL are externalized with a 23-gauge forceps and fixated in a scleral tunnel. Two clockwise scleral incisions are made using a 23-gauge needle at an angle 30 degrees above the sclera. A 3-piece IOL is inserted into the anterior chamber with an injector through the cornea incision, and the trailing haptic is kept outside to prevent the IOL from falling into the vitreous cavity. The leading haptic is held wit a forceps and extracted from the eye through the scleral incisions. The trailing haptic is held with a forceps and both haptics externalized onto the sclera. The conjunctival incisions are closed with 8-0 absorbable sutures tied to fixate 1 haptic (2 o'clock) after 1 more bite on the scleral bed.