Surgeons often face significant challenges when managing aphakia. While several methods exist, iris-claw lens implantation provides a reliable solution for eyes without capsular support. However, traditional enclavation techniques often require significant surgical experience and precision. Recently, experts introduced the Needle Assisted Iris-claw Lens (NAIL) technique to address these common clinical issues.

The NAIL approach utilizes a 10-0 prolene straight needle as an internal pivot. Specifically, this needle acts as a guide during the enclavation process. Consequently, the surgeon can achieve better control and centration of the intraocular lens. In addition, the needle effectively stabilizes the lens during fixation to the iris tissue. Furthermore, clinical data shows promising outcomes with fewer postoperative complications.

Advantages of the NAIL technique for iris-claw lens implantation

For instance, the technique effectively reduces the risk of pupil ovalization. Proper centration remains vital for optimal visual outcomes and patient satisfaction. Overall, NAIL appears to be an efficient and reproducible alternative for most practitioners. Moreover, it significantly lowers the intraoperative difficulty of the procedure compared to manual methods. Clinicians find this approach particularly useful in complex cases requiring high precision.

How does the NAIL technique improve lens centration?

The NAIL technique uses a 10-0 prolene straight needle as an internal pivot point. This needle guides the enclavation process and ensures the lens remains perfectly centered over the pupil throughout the fixation steps.

What are the primary benefits of using a needle guide?

Using a needle guide simplifies the enclavation maneuver and increases surgical precision. It specifically reduces intraoperative challenges and helps prevent common complications like pupil distortion or IOL decentration.

Disclaimer: This content is for informational and educational purposes only. It does not constitute medical advice or professional services. Always seek the advice of a physician or other qualified health provider regarding any medical condition. Refer to the latest local and national guidelines for clinical practice.

References

Palan P et al. Needle-assisted iris-claw lens implantation: A novel, simplified technique for aphakia without capsular support. Indian J Ophthalmol. 2026 May 01. doi: 10.4103/IJO.IJO_1736_25. PMID: 42060946.

Gonnermann J et al. Retropupillary fixation of an iris-claw intraocular lens in aphakic eyes. J Cataract Refract Surg. 2012;38(12):2095-2101.

Biraghi L. New enclavation technique for iris-claw lens. ESCRS Innovative Category. 2019.