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To report the results of a new technique for intraocular lens scleral fixation of temporary haptic externalizationand four-point fixation for enhanced stability. Methods: Two 10-0 polypropylene strands were fixed at two points 2 mm apart on each haptic of a conventionalthree-piece intraocular lens, using our previously reported method of temporary haptic externalization afterinjector implantation. Postoperative refractive outcome and stability were evaluated. Results: Although the intraocular lens was fixed at a total of four points, no intraoperative difficulties were observedduring the process. Patients showed successful fixation of the intraocular lens postoperatively. Thefixed intraocular lens showed good centering and minimal tilting. When compared to the two-point fixationtechnique, postoperative astigmatism was significantly smaller in the four-point fixation group (1.80 ± 0.84 vs. 1.00 ± 0.0.50, p = 0.033). Lens-induced astigmatism calculated from subtraction of corneal astigmatism fromtotal astigmatism was also significantly smaller in the four-point fixation group (2.23 ± 0.98 vs.1.17 ± 0.0.70, p =0.043). No postoperative complications were identified during a mean follow-up period of 14.8 months (range,10 to 19 months). Conclusions: By fixing the intraocular lens at two points on each side of the haptics, this method minimizes thetilting of the intraocular lens and thus decreases postoperative lens-induced astigmatism. Also, the possibilityof intraocular lens dislocation in the long term might be decreased by this two-point fixation technique.
