The novel haptic-twist method for a sutureless double-needle intrascleral haptic fixation technique

Purpose Description of a novel modified technique known as haptic-twist method for placing a trailing haptic into a 27 G needle during double-needle intrascleral haptic fixation (Yamane technique) in the absence and/or inadequacy of capsular support. Methods The trailing haptic was threaded into the needle lumen using a haptic-twist method in 12 eyes of 11 patients with aphakia. The haptic was grasped by a forceps 2-3 mm from the tip, while the forceps was rotated by 180 degrees counter-clockwise around its own axis. This maneuver enabled the trailing haptic to be slightly twisted without any deformation and to coordinate with the needle in the proper angle. The surgical technique has also been mentioned in a surgical video. Results Mean age of the patients was 62 years +/- 18 (range 46-78 years). Although the mean pre-operative best-corrected visual acuity was 0.70 +/- 0.35 logarithm of the minimum angle of resolution (logMAR) (range 1.30-0.20 logMAR), an improvement of up to 0.40 +/- 0.32 logMAR (range 1.0-0.1 logMAR) was observed 3 months after surgery. No trailing haptic bending or breakage was observed during the process. Furthermore, no optical tilting or decentralization was observed post-operatively. Conclusions Although threading the leading haptic into the needle is reasonably straightforward, the trailing haptic positioning can be difficult due to an inappropriate gesture of both the haptic and the needle. We fervently believe that this novel haptic-twist method can provide a much simpler and easier approach, and thus contribute to better surgical outcomes.