ArticleBMC ophthalmology2026
Needle bevel-guided standardisation of scleral tunnel formation in intrascleral haptic fixation: a quantitative geometric analysis.
Article in BMC ophthalmology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundScleral tunnel formation during Yamane double-needle intrascleral haptic fixation (ISHF) depends on proprioceptive estimation, producing variable tunnel lengths that contribute to intraocular lens (IOL) malalignment. The aim of this study was to evaluate a needle bevel-guided technique using the innate 2 mm bevel of a 26-gauge needle as a visual endpoint for standardising intrascleral tunnel length, and to assess postoperative IOL positional stability using a quantitative geometric landmark framework.
methodsRetrospective consecutive case series of 24 eyes undergoing ISHF in the horizontal meridian (3- and 9-o'clock positions) by a single surgeon. During scleral needle advancement, the bevel disappearance point was used to standardise tunnel length to approximately 2 mm at each fixation site. IOL centration was quantified by extracting limbus centre (L) and optic centre (O) from intraoperative and 6-month images, and flange coordinates (F1, F2) from intraoperative images only using Fiji/ImageJ (National Institutes of Health, Bethesda, MD, USA; version 2.14.0/1.54f). The primary outcome was longitudinal Euclidean displacement of the optic centre.
resultsMean best-corrected visual acuity improved from 1.28 ± 0.54 to 0.52 ± 0.47 logMAR (p < 0.001). Mean IOL decentration was 0.401 ± 0.240 mm at baseline and 0.397 ± 0.234 mm at 6 months (mean change - 0.004 mm; p = 0.457). Mean Euclidean displacement was 0.029 ± 0.018 mm; no eye demonstrated displacement exceeding 0.06 mm. No haptic extrusion, IOL dislocation, or sight-threatening complications occurred.
conclusionsThe needle bevel provides a simple, reproducible, and cost-free visual cue for standardising intrascleral tunnel length during ISHF and was associated with excellent longitudinal positional stability. Initial centration, governed by entry angle and chord length symmetry, remains a separate challenge requiring complementary strategies.
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