Secondary single-piece toric posterior chamber intraocular lens fixation

The intended axis of fixation of a dislocated TECNIS single-piece toric posterior chamber intraocular lens (PC IOL) is identified, and a marker is placed 40 degrees counterclockwise to this axis. A polypropylene suture on a straight needle is passed 2.5 mm posterior to the limbus through a scleral flap at this meridian and into the bore of the needle inserted through a paracentesis at the opposite margin, then the needle is retracted, reinserted, and captured through a second needle inserted through the scleral flap adjacent to the first suture pass, leaving a loop of suture outside of the paracentesis. The haptic of the PC IOL is externalized through another paracentesis made at the scleral flap margin. The loop of suture is pulled into the anterior chamber and out of the latter paracentesis. A cow-hitch knot is fastened around the haptic, which is then repositioned, while the suture is tightened until the PC IOL is in its final aligned position.