FEB 15, 2017
Video Journal of Cataract & Refractive Surgery
Dr. John C. Hart Jr. demonstrates his technique for IOL iris fixation, which mitigates the risk of pupillary distortion common with the procedure. After placement of a 3-piece IOL anterior to the pupil, with the haptics positioned posterior to the iris, Dr. Hart cuts one needle from a joined CTC-6L suture set and passes it through the iris to capture the haptic. The needle tip is swept towards the iris root and driven out at the peripheral cornea, which stretches, lifts, and stabilizes the iris so that smaller suture bites can be made. The fixation needle also decreases the angle between the iris and the cornea, limiting internal reflection and improving peripheral visualization. With the fixation needle in place, the surgeon passes the second needle through the same paracentesis to place fixation sutures close to the limbus on the captured haptic. As the knots incarcerate less tissue and lie closer to the limbus, distortion is less likely to occur. However, the optic should be prolapsed through the pupil before the knots are locked, as this shift will change suture tension.