Adjustable Flange Technique for Scleral Fixation of Single-Piece IOL

Drs. Ekjyot Gill and David Mostafavi demonstrate a modification of the Yamane technique. They use 6-0 polypropylene sutures and high-temp cautery to create a small bulb on the tip of both ends of the suture for scleral fixation of a single-piece IOL. As described by Drs. Ehud Assia and John Wong in their original paper, the benefits of this technique include the ease of suture capturing and threading rather than using a haptic. Added benefits include the ability to adjust suture length on each side after IOL implantation to achieve satisfactory suture tension and IOL position. 

The first surgeon to describe this method was Dr. Sergio Canabrava from Brazil, with the Canabrava 4-Flanged Technique, but he does not currently recommend it as he has observed an excessive number of tilts in his studies.  

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