Comparative analysis of outcomes of two (popular) techniques of haptic exteriorization in scleral fixation intra-ocular lens surgery – A retrospective study

Dear Editor, We have read the article by Baskaran P et al. titled “comparative analysis of outcomes of two (popular) techniques of haptic exteriorization in scleral fixation intra-ocular lens surgery – A retrospective study”[1] and congratulate them upon publishing such an innovative surgical technique. Taking the opportunity, we would like to add on to the topic. At our tertiary healthcare center, we have also been using a novel technique of haptic exteriorization. Description of surgical technique After peritomy, the superior sclero-corneal tunnel is made followed by creating two Hoffman pockets at 3 and 9’o clock. Just medial to each pocket, full thickness pin point stab incision is made to exteriorize the haptics of SFIOL. A 26 G needle is bent at 60 degrees angle, and the silicon stopper of the iris hook is fixed at the junction of the straight and bent parts in a longitudinal fashion so that the needle has to pierce the stopper and not just go through the pre-made hole as shown in [Fig. 1a and b]. The needle is inserted via stab incision and brought to the sclero-corneal tunnel surface to insert the leading haptic of SFIOL. After inserting the haptic into the needle’s lumen, the needle is brought back in reverse fashion, and the stopper is receded to be placed upon the haptic of SFIOL. Similarly, the lagging haptic is also exteriorized.Figure 1: (a) 26 G needle with insertion of iris hook stopper. (b) Orientation of iris hook stopperWith the help of such low-cost “Do It Yourself” instrument, lesser haptic slippage and decreased surgical duration are noted. No visually significant complications have been noted so far. Good IOL centralization is also maintained post-operatively. Financial support and sponsorship: Nil. Conflicts of interest: There are no conflicts of interest.