Trans-iris vertical intrascleral haptic fixation of IOL: The bypass technique in eyes with megalocornea

Intrascleral haptic fixation of intraocular lens (IOL) is an extremely useful technique to provide visual rehabilitation in eyes with inadequate capsular support. It requires exteriorization of haptics along with tucking of haptics in the scleral groove preferably and conventionally in the horizontal meridian. In eyes with large corneal diameter, there is difficulty in tucking enough length of the haptics into the intrascleral groove, carrying the risk of slippage of haptics and decentration of IOL. To exteriorize a larger segment of haptic for tucking, we describe a novel technique that involves creation of scleral groove at the posterior limbus and exteriorization of haptic through a small peripheral iridectomy through the posterior limbus. This provides a larger segment of haptic to tuck into the groove that might prevent slippage and decentration of IOL in eyes with megalocornea.