Three Port Sutureless Posterior Chamber Intraocular Lens Intrascleral Fixation: A Novel Approach.

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Several techniques have been reported in the literature for secondary posterior chamber intraocular lens (IOL) implantation in the setting of inadequate capsular support, whether during secondary lens implantation or IOL rescue/exchange after subluxation or dislocation, including sutured iris fixation, scleral fixation, and intrascleral haptic capture. The latter is performed with three-piece acrylic IOLs where the two polypropylene haptics are externalized through the sclera for IOL fixation. The transconjunctival sutureless intrascleral (SIS) fixation IOL technique originally described by Prasad1 uses a total of five vitrectomy trocar/cannulas—three for the pars plana vitrectomy (PPV) and two for the IOL fixation. In this article, we demonstrate a novel approach to the sutureless, transconjunctival SIS technique, using only the three standard cannula ports required for PPV, whereby we demonstrate that successful scleral fixation is feasible without the need for additional cannulas or incisions.