ABSTRACT Purpose: To evaluate the efficacy and safety of the modified Yamane technique with sutureless transconjunctival intrascleral intraocular lens fixation. Methods: Sutureless transconjunctival intrascleral haptic fixated intraocular lens implantation was performed in patients with aphakia and dislocated intraocular lenses. A clear corneal incision (2.8 mm) was made into the temporal quadrant and a three-piece intraocular lens was implanted into the anterior chamber. The haptics of the intraocular lens were externalized with a 27 G needle via transconjunctival scleral tunnels at the 6 and 12 o’clock positions. The transconjunctival scleral tunnels were prepared to conform to the haptic position and curvature. The site of the scleral tunnels was 2mm from the limbus with a length of 2 mm in the sclera and was aimed at the end of the posterior chamber. The tips of the haptics were cauterized to create a terminal knob. The haptics were pushed back and the knobs were implanted into the scleral tunnels. Results: The study cohort included 21 patients with unilateral aphakia and dislocated intraocular lenses. All patients were examined postoperatively and at postoperative day 1, day 7, month 1, and month 3. All examinations revealed formation of the anterior chamber and well-centralized intraocular lenses. No haptic-related complications of exposure, foreign body sensation, or discomfort were observed. Conclusion: Sutureless transconjunctival intrascleral haptic fixated intraocular lensimplantation is an effective, safe, and practical surgical alternative. This technique was superior to the Yamane method with regard to comfort and surgical duration. Further studies with longer follow-up evaluations are warranted to verify long-term complications.

PURPOSE: To describe a technique of monoscleral fixation of the intraocular lens (IOL) after extracapsular extraction of subluxated lens in patients with Marfan syndrome. Design: Noncomparative, interventional case series. METHODS: A retrospective study was conducted on 14 eyes of 7 consecutive patients with subluxated lens associated with Marfan syndrome. Surgery was indicated when: 1) a lens border was observed in the pupil area with the pupil under normal lighting causing glare; or 2) the best corrected visual acuity was less than 20/70; or 3) the patient complained of monocular diplopia. Patients with a history of glaucoma, retinal detachment, trauma or other systemic diseases were excluded. RESULTS: The mean postoperative follow-up was 15.43 ± 9.33 months (range, 6 to 30 months). The best spectacle-corrected visual acuity varied from 20/25 to 20/60, where 71.43% reached 20/30 or better. No case showed a worsening of visual acuity, nor were there any intraoperative or postoperative complications (intraocular lens decentration, pupilar block, glaucoma or retinal detachment). The most frequent postoperative complication was astigmatism, observed in 3 eyes (21.43%) presenting values greater than 1.5 D. CONCLUSIONS: This technique showed very good surgical and visual results and few complications, providing a surgical option for cases of ectopia lentis associated with Marfan syndrome, especially in some countries or regions where phacoemulsification is not available.