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Indian J Ophthalmol. 2017 Aug;65(8):747-750. doi: 10.4103/ijo.IJO_296_17.

Extraocular needle- guided haptic insertion technique of scleral fixation intraocular lens surgeries (X-NIT).

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Department of Vitreo Retina, Aravind Eye Hospital, Puducherry, India.
Department of Cornea & Refractive Surgery, Aravind Eye Hospital, Puducherry, India.
Department of Glaucoma, Aravind Eye Hospital, Puducherry, India.
Department of IOL, Aravind Eye Hospital, Puducherry, India.


The most challenging step in sutureless scleral fixation of intraocular lens (SFIOL) is exteriorization of haptics. The conventional handshake technique has a learning curve since it involves intraocular handing over of haptics from one forceps to another. Here, we describe "extraocular needle-guided haptic insertion technique" (X-NIT), a novel technique of exteriorizing haptics that totally eliminates intraocular manipulations. This method involves sequential introduction of two bent 26-gauge needles through the sclera (pars plicata zone) into the eye which are brought out through a sclerocorneal wound. The intraocular lens haptics are threaded through these needles and exteriorized. Nineteen consecutive patients underwent surgery by this technique. There were no intraoperative complications. The mean best-corrected visual acuity (BCVA) of these patients at 1-month follow-up was 0.5 ± 0.3 (logarithm of the minimum angle of resolution) with 18 of 19 eyes showing one or more lines of improvement in BCVA. X-NIT is a safe, easy, cost-effective, and highly reproducible technique, especially for beginners.

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