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Volume 15
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Needle-Guided Scleral Fixation: A New Single-Suture Approach

by
Laura De Luca
1,
Giovanni William Oliverio
1,
Maura Mancini
1,
Rino Frisina
2,
Feliciana Menna
3,*,
Stefano Lupo
3,
Pierluigi Grenga
4,
Cosimo Mazzotta
5,
Pasquale Aragona
1 and
Alessandro Meduri
1
1
Ophthalmology Clinic, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy
2
Ophthalmology Unit, Surgery Department, Piacenza Hospital, 29121 Piacenza, Italy
3
Department of Medical-Surgical Sciences and Biotechnologies, U.O.C. Ophthalmology, Sapienza University of Rome, Via Firenze 1, 04019 Terracina, Italy
4
Ophthalmology Unit UOC, ASL Roma 3 G.B. Grassi Hospital, Ostia Lido, 00122 Rome, Italy
5
Faculty of Medicine and Surgery, University of Enna “Kore”, 94100 Enna, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2026, 15(1), 78; https://doi.org/10.3390/jcm15010078 (registering DOI)
Submission received: 2 October 2025 / Revised: 13 November 2025 / Accepted: 8 December 2025 / Published: 22 December 2025
(This article belongs to the Special Issue New Insights in Ophthalmic Surgery)
Versions Notes

Abstract

Background: Scleral fixation of intraocular lenses (IOLs) is a valuable option in cases of aphakia or inadequate capsular support, yet conventional sutured and sutureless approaches can pose technical challenges and complication risks. The needle-guided scleral fixation technique offers a simplified, single-suture solution that enhances safety and reproducibility. Methods: In this retrospective interventional case series, 30 eyes with insufficient capsular support underwent IOL implantation using Meduri’s needle-guided single-suture technique at the G. Martino University Hospital, Messina. The surgical method employs a 24-gauge needle to guide a double-armed 10-0 polypropylene suture through the sclera for precise IOL anchorage, minimizing vitreous manipulation. Outcomes were assessed over 24 months, including best-corrected visual acuity (BCVA), IOL centration, intraocular pressure (IOP), and postoperative complications. Results: Mean BCVA improved from X to Y LogMAR at two years (p < 0.05). All IOLs remained well-centered without tilt or decentration. Mild conjunctival hyperemia occurred in 70% of cases, resolving spontaneously. No suture erosion, vitreous hemorrhage, or retinal detachment was observed. Conclusions: The needle-guided single-suture technique provides a stable, efficient, and reproducible method for posterior chamber IOL fixation in aphakic eyes lacking capsular support. Its minimal learning curve and reduced surgical complexity make it an attractive alternative to both traditional sutured and modern sutureless methods, particularly in centers without vitreoretinal expertise.
Keywords: scleral fixation; aphakia; IOL malposition; needle-guided scleral fixation scleral fixation; aphakia; IOL malposition; needle-guided scleral fixation

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MDPI and ACS Style

De Luca, L.; Oliverio, G.W.; Mancini, M.; Frisina, R.; Menna, F.; Lupo, S.; Grenga, P.; Mazzotta, C.; Aragona, P.; Meduri, A. Needle-Guided Scleral Fixation: A New Single-Suture Approach. J. Clin. Med. 2026, 15, 78. https://doi.org/10.3390/jcm15010078

AMA Style

De Luca L, Oliverio GW, Mancini M, Frisina R, Menna F, Lupo S, Grenga P, Mazzotta C, Aragona P, Meduri A. Needle-Guided Scleral Fixation: A New Single-Suture Approach. Journal of Clinical Medicine. 2026; 15(1):78. https://doi.org/10.3390/jcm15010078

Chicago/Turabian Style

De Luca, Laura, Giovanni William Oliverio, Maura Mancini, Rino Frisina, Feliciana Menna, Stefano Lupo, Pierluigi Grenga, Cosimo Mazzotta, Pasquale Aragona, and Alessandro Meduri. 2026. "Needle-Guided Scleral Fixation: A New Single-Suture Approach" Journal of Clinical Medicine 15, no. 1: 78. https://doi.org/10.3390/jcm15010078

APA Style

De Luca, L., Oliverio, G. W., Mancini, M., Frisina, R., Menna, F., Lupo, S., Grenga, P., Mazzotta, C., Aragona, P., & Meduri, A. (2026). Needle-Guided Scleral Fixation: A New Single-Suture Approach. Journal of Clinical Medicine, 15(1), 78. https://doi.org/10.3390/jcm15010078

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