Abstract
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° 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.
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TE and HHG were responsible for study design and recruitment of participants; surgery and follow-up of patients; data analysis, reviewing, editing and verifying the accuracy of the manuscript. Complete access to all study data and accountability for data integrity and accuracy of data analysis were performed by TE. Not: TE = Tansu Erakgun; HHG = Hamidu Hamisi Gobeka.
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An angled sclerotomy on the left side was made with a 27 G bevel-up needle, 2 mm from the limbus, to engage the leading haptic. The intraocular forceps was used to thread the leading haptic into the needle lumen. After securing the haptic, the needle was removed to externalize the haptic. The second sclerotomy was made with 27 G bevel-up needle 180° away in similar fashion to the first one. The intraocular forceps was inserted through the paracentesis to thread the trailing haptic into the needle lumen. The haptic was slightly twisted around its own axis without deformation and aligned with theneedle lumen in the proper angle. The trailing haptic was then externalized and the tip was heated with a low-temperature cautery to create a flange which was pushed back and fixed intrasclerally. (MP4 177088 kb)
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Erakgun, T., Gobeka, H.H. The novel haptic-twist method for a sutureless double-needle intrascleral haptic fixation technique. Int Ophthalmol 41, 3013–3020 (2021). https://doi.org/10.1007/s10792-021-01862-6
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DOI: https://doi.org/10.1007/s10792-021-01862-6