Iris suture fixation: Push-knot needle.

We describe a technique to create a locking knot for iris reconstruction or intraocular lens fixation. A modified needle is prepared by straightening the tip of an ophthalmic viscosurgical device needle or a lacrimal cannula needle. After the suture is passed through 2 sides of an iris defect, the 2 ends are externalized and looped. One strand is then inserted into the needle from the tip out of the ferrule, and the knot is pushed into the anterior chamber by this needle in a controllable manner. Two other locking knots are then made by repeating the process. With this method, only 1 small corneal incision is necessary regardless of the number of knots required and only a small amount of anterior chamber space is needed during the knotting process.