In the McCannel [1, 2] suture technique (Fig. 24.2), another paracentesis is created directly over the position of the haptic to be fixated. Through this paracentesis, a hook is used to loop out the proximal and distal segments of the suture. The two loops are cut to obtain two suture ends. These suture ends are thrown into a loop, knot slipped into the anterior chamber, and tightened over the haptic and overlying iris (2–1 suture knot). To prevent pupil ovalization, iris tissue should not bunch under the first knot, and the first knot should not be too tight. Also, before the first knot is tightened, the optic can be repositioned posteriorly through the pupil in posterior chamber and the round shape of the pupil ascertained.

In the technique implementing Siepser slipknot [3] (Fig. 24.3), the additional paracentesis directly over the haptic is not required. The distal portion of the suture is looped out from inside the eye through the proximal paracentesis, while retaining the distal end of the suture accessible through the distal paracentesis. The proximal end of the suture is twice thrown into a knot through the distal portion of the suture, which has already been looped out through the proximal paracentesis. Then the distal and the proximal ends are pulled apart, from their respective paracenteses, so that the knot slides into place on the iris over the haptic. To avoid pupil ovalization, the same measures, as described previously, are taken. The process is repeated once for another throw (2–1 suture knot).