External Transscleral Posterior Chamber Lens Fixation

To the Editor.  —I am involved in a resident teaching program and I am acutely aware of the difficulties encountered by trainees passing the needle from the limbus under the iris and through a previously prepared scleral bed. Shapiro and Leen's¹ method of passing the needle in the opposite direction is excellent. This approach also has a disadvantage. The learning surgeon has difficulty tying the suture to the haptic of the intraocular lens. This difficulty is compounded in the authors' approach, for the surgeon now has only one end of the suture available to manipulate. This adds considerably to the time that the globe is open during the operation. One solution would be initially to limit the size of the opening at the 12 o'clock position to 1 to 2 mm. After the haptics are tied, the incision could be increased in size.The authors used a separate polypropylene