Background: To report a modified surgical technique for intrascleral intraocular lens (IOL) fixation with fewer\nanterior segment manipulations in eyes lacking sufficient capsular support.\nMethods: Eyes from 14 patients who underwent 27-gauge needle-guided intrascleral IOL fixation with built-in 8â??0\nabsorbable sutures were studied. The 8-0 absorbable sutures were inserted into 27-gauge round needles and used\nto create sclerotomies at the 4 oâ??clock and 10 oâ??clock positions under the scleral flap. The sutures were used to tie\nknots at the end of each haptic and guide haptic externalization through the sclerotomy. After externalization, a\nsufficient flange was created at the end of each haptic and fixed under the scleral flaps. The best corrected visual\nacuity (BCVA), corneal endothelial cell density (ECD), IOL tilt and decentration, previous surgery history, and\ncomplications were determined.\nResults: Fourteen cases were analyzed. The majority of eyes exhibited an improvement in the BCVA after surgery.\nWhen comparing the last follow-up to preoperative visual acuity, the mean change in BCVA was + 26.32 letters\n(p = 0.011). Postoperative complications included postoperative hypotony in 3 eyes, ocular hypertension in 2 eyes.\nNo cases of postoperative cystoid macular edema (CME), vitreous hemorrhage (VH), IOL dislocation, or\nendophthalmitis were observed.\nConclusions: The 27-gauge needle-guided intrascleral IOL fixation technique with built-in 8â??0 absorbable sutures is\neasy to perform with fewer anterior chamber manipulations and achieves both anatomical and optical stability.
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