The Yamane technique of scleral IOL fixation has grown in popularity over the years and it is a good choice for cases lacking capsular support. But there are potential issues including a higher risk of retinal complications (retinal break, cystoid macular edema) and also IOL related problems such as this case. Our guest surgeon does a great job of completing a pars plana vitrectomy and then precisely places the needles to aid in scleral fixation. When the second haptic is placed into the bore of the needle to be externalized, it becomes disinserted from the optic. Look at the photo and you can see the empty channel in the IOL optic where the haptic was previously embedded. Remember that most of these IOLs have hand-staked haptics which are a friction fit without glue or adhesives. What would you do now? Comment below, please.
