Correct positioning essential for handshake technique

Appropriate positioning of the surgeon and the patient’s eye is essential, and the goal in selecting and adjusting a particular surgical position is to maintain the ease of surgery while allowing proper and adequate access to the surgical site.The handshake technique is an essential prerequisite for performing glued IOL surgery, and its applicability and importance cannot be undermined by any measures. This technique essentially comprises the transfer of haptics from one hand to another until the tips of the haptics are grasped and externalized from the respective sclerotomy sites. Knowledge of this technique is also essential to manage malpositioned IOLs and the slippage of haptics from the sclerotomy sites, where it comes as a rescue measure to aid the surgeon. Another important nuance of this technique is the movement of the surgeon’s hand, which follows the direction of the curvature of the haptics that are being manipulated. Doing so eliminates the possibility of breakage of the haptics due to inadvertent pull in the wrong direction. The main consideration in doing so is the appropriate positioning of the surgeon while performing the surgery (Figures 1a and 1b).