Digitally Aligned, Scleral-Fixated, Haptic Punch-and-Rescue of a Toric IOL

Dr. Morgan Micheletti presents a case of an intraocular, horizontal haptic punch-and-rescue with scleral fixation of a toric IOL on axis. In the originally described punch-and-rescue technique, the approach was to create a vertical hole in the haptic-optic junction. One possible limitation of that approach is the risk of tilt, given the perpendicular plane of the suture relative to the IOL. In this case, the haptics were punched in a horizontal fashion and a double flange was placed in-plane with the haptics, which reduces tilt. While technically more challenging, this approach may improve outcomes in cases of dislocated toric or advanced-technology IOLs.

Financial Disclosures: Dr. Morgan Micheletti discloses financial relationships with Alcon Laboratories, Johnson & Johnson Vision (Consultant/Advisor, Lecture Fees/Speakers Bureau, Grant Support), Allergan (Consultant/Advisor, Grant Support), Avellino Labs, Bausch + Lomb, Beaver-Visitec International, Carl Zeiss Meditec, Centrecity Vision, New World Medical, Tarsus Pharmaceuticals, Visus Therapeutics (Consultant/Advisor), Diamatrix (Lecture Fees/Speakers Bureau, Patents/Royalty), Glaukos Corporation, RxSight, STAAR Surgical (Consultant/Advisor, Lecture Fees/Speakers Bureau), and Ophthalmic Neo-Innovations of Texas (Patents/Royalty, Owner of Company).