Our guest surgeon is performing Dr Soosan Jacob’s 5F Technique which is a refined approach to sutureless intrascleral haptic fixation (ISHF), designed to simplify the rescue of intraocular lenses in the absence of capsular support. By eliminating the need for complex maneuvers, it minimizes surgical trauma and postoperative complications.
The 5F Breakdown
The technique is defined by five key “F” principles:
- Flangeless: Unlike the Yamane technique, it does not require thermal cautery to create a bulbous tip (flange) on the haptic.
- Flapless: No scleral flaps are dissected, significantly reducing surgical time and the risk of flap-related erosions.
- Fibrin Glue-less: The stability is mechanical, removing the need for expensive biological adhesives.
- Fully Covered: The haptics are tucked entirely within a long scleral tunnel.
- Fully Tucked: Both haptics are buried deep within the scleral architecture to prevent exposure.
Surgical Procedure
The surgeon uses a thin-walled needle (typically 30G) to create a long, tangential scleral tunnel parallel to the limbus. The IOL haptics are exteriorized through a sclerotomy and then tucked into these tunnels. The friction and the length of the tunnel provide robust stability. This method is particularly valued for its low-tech, high-efficiency nature, making it accessible for surgeons who may not have access to specialized glues or who wish to avoid the potential for haptic-induced conjunctival erosions. This new 5F procedure seems to be a better approach than Yamane! What do you think?
