Trailing-haptic-first modification of double-needle intrascleral haptic fixation technique

The Yamane double-needle intrascleral haptic fixation technique for posterior chamber intraocular lens (IOL) fixation in the setting of absent or inadequate capsule support is a minimally invasive IOL fixation technique that requires scleral incisions using needles to externalize the IOL haptics. Despite being a seemingly easy and intuitive procedure, there are significant challenges when learning this technique. The most difficult step is threading the trailing haptic with the needle for fixation. If using an IOL with weak haptics, this step can result in haptic kink or breakage, which renders the haptics useless for this technique and necessitating explantation of the IOL. Even when an IOL with strong and rigid haptics is used, the rigid haptics make threading the trailing haptic the most difficult step. The trailing-haptic-first technique is a distinct modification that enhances the ease and success of the double-needle technique.