By Amar Agarwal, MD
    Video Journal of Cataract and Refractive Surgery
    Cataract/Anterior Segment

    This video shows how to use scleral tunnels for haptic fixation in conjunction with the glued IOL technique to fixate a posterior chamber IOL. This technique is demonstrated in a patient with pseudophakic bullous keratopathy whose single-piece posterior chamber IOL had become adhered to the iris. Following a pars plana vitrectomy, the haptics are released slowly from where it adhered to the iris. The handshake technique is then used to externalize the haptics, and a 26-gauge needle is used for scleral tunnel creation and IOL haptic capture. The haptics are then tucked into the scleral pockets and the iris is normalized using modified Seiper's knots. One day after surgery, the graft was well positioned and the cornea was relatively clear.