The usefulness of the "double-needle" technique for combined cataract extraction and corneal transplantation.

The authors report using double-needle cataract extraction in the course of triple surgery and describe the usefulness of a double-needle technique. Before penetrating preparation of the recipient cornea, two straight double-arm 10-0 Prolene needles (Ethicon, Edinburgh, Scotland) were inserted in parallel on the recipient corneal bed transcorneally immediately anterior to the iris. The use of two needles stabilized the iris plane and offset positive vitreous pressure during triple surgery, continuous curvilinear capsulorrhexis, phacoemulsification, irrigation, and aspiration, allowing the safe implantation of an intraocular lens in the bag in an open-sky state. There were no procedural difficulties and no complications. This simple technique using double needles in triple surgery can be used effectively and may prevent forward movement of the lens-iris diaphragm, anterior capsular tearing, and rapid expulsion of the lens caused by positive vitreous pressure in the open-sky state.