{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:51:06Z","timestamp":1787028666193,"version":"build-2736575974"},"reference-count":29,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>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\u2019s 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 &lt; 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.<\/jats:p>","DOI":"10.3390\/jcm15010078","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T14:27:51Z","timestamp":1766586471000},"page":"78","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Needle-Guided Scleral Fixation: A New Single-Suture Approach"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3513-5826","authenticated-orcid":false,"given":"Laura","family":"De Luca","sequence":"first","affiliation":[{"name":"Ophthalmology Clinic, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni William","family":"Oliverio","sequence":"additional","affiliation":[{"name":"Ophthalmology Clinic, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2615-436X","authenticated-orcid":false,"given":"Maura","family":"Mancini","sequence":"additional","affiliation":[{"name":"Ophthalmology Clinic, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0247-2680","authenticated-orcid":false,"given":"Rino","family":"Frisina","sequence":"additional","affiliation":[{"name":"Ophthalmology Unit, Surgery Department, Piacenza Hospital, 29121 Piacenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4347-6573","authenticated-orcid":false,"given":"Feliciana","family":"Menna","sequence":"additional","affiliation":[{"name":"Department of Medical-Surgical Sciences and Biotechnologies, U.O.C. Ophthalmology, Sapienza University of Rome, Via Firenze 1, 04019 Terracina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9962-7489","authenticated-orcid":false,"given":"Stefano","family":"Lupo","sequence":"additional","affiliation":[{"name":"Department of Medical-Surgical Sciences and Biotechnologies, U.O.C. Ophthalmology, Sapienza University of Rome, Via Firenze 1, 04019 Terracina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierluigi","family":"Grenga","sequence":"additional","affiliation":[{"name":"Ophthalmology Unit UOC, ASL Roma 3 G.B. Grassi Hospital, Ostia Lido, 00122 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1829-9288","authenticated-orcid":false,"given":"Cosimo","family":"Mazzotta","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Surgery, University of Enna \u201cKore\u201d, 94100 Enna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9582-9799","authenticated-orcid":false,"given":"Pasquale","family":"Aragona","sequence":"additional","affiliation":[{"name":"Ophthalmology Clinic, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Meduri","sequence":"additional","affiliation":[{"name":"Ophthalmology Clinic, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.1016\/j.jfo.2021.05.002","article-title":"FIL-SSF Carlevale intraocular lens for sutureless scleral fixation: 7 recommendations from a series of 72 cases","volume":"44","author":"Rouhette","year":"2021","journal-title":"J. Fr. Ophtalmol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e26728","DOI":"10.1097\/MD.0000000000026728","article-title":"Comparison of two different scleral fixation techniques of posterior chamber Carlevale lens","volume":"100","author":"Fiore","year":"2021","journal-title":"Medicine"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2034","DOI":"10.1097\/IAE.0000000000003338","article-title":"Modified Carlevale Intraocular Lens Fixation Technique: Two Vitrectomy Ports as Lens Plug Fixation Sites","volume":"43","author":"Tomaso","year":"2023","journal-title":"Retina"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Forlini, M., Soliman, W., Bratu, A., Rossini, P., Cavallini, G.M., and Forlini, C. (2015). Long-term follow-up of retropupillary iris-claw intraocular lens implantation: A retrospective analysis. BMC Ophthalmol., 15.","DOI":"10.1186\/s12886-015-0146-4"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2255","DOI":"10.1007\/s40123-024-00986-z","article-title":"A new technique with scleral grooves for sutureless scleral fixation of the Carlevale intraocular lens","volume":"13","author":"Giannopoulos","year":"2024","journal-title":"Ophthalmol. Ther."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1177\/1120672121992978","article-title":"Scleral fixation of Carlevale intraocular lens: A new tool in correcting aphakia with no capsular support","volume":"32","author":"Georgalas","year":"2022","journal-title":"Eur. J. Ophthalmol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1097\/ICU.0000000000000632","article-title":"Scleral fixation of intraocular lenses","volume":"31","author":"Jacob","year":"2020","journal-title":"Curr. Opin. Ophthalmol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1097\/ICU.0b013e32835a939f","article-title":"Glued intraocular lens: A major review on surgical technique and results","volume":"24","author":"Kumar","year":"2013","journal-title":"Curr. Opin. Ophthalmol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1097\/ICU.0000000000001118","article-title":"Scleral fixated intraocular lens techniques for the vitreoretinal surgeon: An update","volume":"36","author":"Khan","year":"2025","journal-title":"Curr. Opin. Ophthalmol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1016\/S0161-6420(02)02000-6","article-title":"Intraocular lens implantation in the absence of capsular support: A report by the American Academy of Ophthalmology","volume":"110","author":"Wagoner","year":"2003","journal-title":"Ophthalmology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1016\/j.ophtha.2017.03.036","article-title":"Flanged intrascleral intraocular lens fixation with double-needle technique","volume":"124","author":"Yamane","year":"2017","journal-title":"Ophthalmology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1433","DOI":"10.1016\/j.jcrs.2008.04.040","article-title":"Fibrin glue\u2013assisted sutureless posterior chamber IOL implantation in eyes with deficient posterior capsules","volume":"34","author":"Agarwal","year":"2008","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"95","DOI":"10.4103\/tjo.TJO-D-23-00163","article-title":"Management of complications of sutureless intrascleral intraocular lens fixation","volume":"14","author":"Cheng","year":"2024","journal-title":"Taiwan J. Ophthalmol."},{"key":"ref_14","first-page":"144","article-title":"Scleral-fixated intraocular lenses: Past and present","volume":"1","author":"Stem","year":"2017","journal-title":"J. Vitr. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1097\/IAE.0000000000004289","article-title":"6\/0 prolene double-flanged intraocular lens sutureless scleral fixation with a 27-gauge needle for intraocular lens surgery","volume":"45","author":"Pao","year":"2025","journal-title":"Retina"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2047","DOI":"10.2147\/OPTH.S302547","article-title":"A Modified Flanged Intrascleral Intraocular Lens Fixation Technique Using an Externalized Needle for Haptic Docking","volume":"15","author":"Ifantides","year":"2021","journal-title":"Clin. Ophthalmol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e129","DOI":"10.3928\/23258160-20181002-15","article-title":"Comparison of Two Modified Sutureless Techniques of Scleral Fixation of Intraocular Lens","volume":"49","author":"Kelkar","year":"2018","journal-title":"Ophthalmic Surg. Lasers Imaging Retin."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.1097\/j.jcrs.0000000000000309","article-title":"Intraoperative Performance and Long-term Postoperative Outcomes following Scleral fixation of Intraocular Lenses with Polytetrafluoroethylene suture","volume":"46","author":"Bhojwani","year":"2020","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_19","unstructured":"Meduri, A., Oliverio, G.W., Borroni, D., Frisina, R., De Luca, L., and Aragona, P. (2024, January 4\u20136). Needle-guided scleral fixation IOL: Easy technique for beginner surgeons. Proceedings of the 5th International Electronic Conference on Applied Sciences, Online."},{"key":"ref_20","first-page":"e70688","article-title":"Secondary Intrascleral Intraocular Lens Fixation with Lens Capsule Preservation for Aphakic Eyes in Patients with Pseudoexfoliation Syndrome: A Case Series","volume":"16","author":"Nakagawa","year":"2024","journal-title":"Cureus"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1332","DOI":"10.1097\/IAE.0000000000004438","article-title":"Long-term Outcomes of Secondary IOL Surgeries Using the Haptic Externalization Scleral Suture Technique","volume":"45","author":"Bison","year":"2025","journal-title":"Retina"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1097\/j.jcrs.0000000000000444","article-title":"In vivo evaluation of a one-piece foldable sutureless intrascleral fixation lens using ultrasound biomicroscopy and anterior segment optical coherence tomography","volume":"47","author":"Mularoni","year":"2020","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.1177\/11206721211049102","article-title":"Combined transconjunctival sutureless three-port vitrectomy and scleral fixation of intraocular lens","volume":"32","author":"Danese","year":"2021","journal-title":"Eur. J. Ophthalmol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"387","DOI":"10.3341\/jkos.2023.64.5.387","article-title":"Comparison of Surgical Outcomes between Conventional Sutured Scleral Fixation and Flanged Intrascleral Intraocular Lens Fixation","volume":"64","author":"Jo","year":"2023","journal-title":"J. Korean Ophthalmol. Soc."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e527","DOI":"10.3928\/1081597X-20240611-04","article-title":"Refractive Outcomes After Scleral Fixation of the Carlevale Intraocular Lens","volume":"40","author":"Courat","year":"2024","journal-title":"J. Refract. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1097\/j.jcrs.0000000000001327","article-title":"Ten-year results of scleral-fixated intraocular lens implantation: Outcomes of ab externo scleral fixation with 10-0 polypropylene suture","volume":"50","author":"Desai","year":"2024","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"94","DOI":"10.3928\/23258160-20210201-06","article-title":"Scleral Fixation of Carlevale Intraocular Lens in Children: A Novel Tool in Correcting Aphakia with No Capsular Support","volume":"52","author":"Gotzaridis","year":"2021","journal-title":"Ophthalmic Surg. Lasers Imaging Retin."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Chen, L., Wang, Z., Sun, L., Tang, Y., Sui, W., Bian, A., Zhang, X., Zhong, Y., and Zhang, S. (2023). Two-way adjustable double-knots intrascleral fixation and single sclerotomy looping technique: A novel minimal invasive adjustable intraocular lens fixation technique. BMC Ophthalmol., 23.","DOI":"10.1186\/s12886-023-03235-2"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s40662-024-00414-0","article-title":"Recent advances and current challenges in suture and sutureless scleral fixation techniques for intraocular lens: A comprehensive review","volume":"11","author":"Sun","year":"2024","journal-title":"Eye Vis."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/1\/78\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,27]],"date-time":"2025-12-27T05:18:18Z","timestamp":1766812698000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/1\/78"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,22]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["jcm15010078"],"URL":"https:\/\/doi.org\/10.3390\/jcm15010078","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,22]]}}}