Long term outcomes of Yamane technique in various indications

Abstract

Introduction To describe the clinical and refractive outcomes of Yamane transconjunctival sutureless intrascleral intraocular lens (SIS IOL) fixation technique in aphakic and dislocated IOLs. Methods The aphakic and IOL dispositioned patients who underwent Yamane surgery in Bozyaka Research and Training Hospital were evaluated retrospectively. The demographic data, preoperative & postoperative best-corrected visual acuity (BCVA), spherical equivalent (SE), indication for surgery, additional surgical interventions, complications, the final status of retina, and central macular thickness (CMT) through spectral-domain optic coherence tomography (SD-OCT) were recorded. Results A total of 30 eyes of 30 patients were evaluated. The indication for surgery was aphakia in 24 patients, lens dislocation in 1 patient, and IOL dislocation in 5 patients. The mean age of participants was 64.17 ± 14.69 years, and the mean follow-up was 46.07 ± 7.96 months. The mean BCVA was improved from 0.25 ± 0.22 (−0.94 ± 0.83 log MAR) to 0.49 ± 0.24 in decimals (−0.37 ± 0.27 log MAR) (p:0.041). The mean subjective refraction improved from 10.06 ± 3.10 to −1.45 ± 0.73 D in the final visit (p < 0.05). The mean of cylindrical refraction was −1.22 ± 1.03 D in the postoperative period. At the time surgery, 36.6% of patients required at least one additional surgical procedure. During follow-up period, two (6.7%) out of 30 of patients had retinal detachment, two of the patients (6.7%) occured epiretinal membrane, one of the patients (3.3%) had cystoid macular edema. Conclusion Yamane SIS IOL fixation technique is an effective and reliable surgical option in complicated cases that require additional surgical interventions in long-term follow-up.

Application of modified Yamane technique in intrascleral intraocular lens fixation combined with or without iris reconstruction

“…Among the 11 patients who received combined IOL fixation and other procedures, such as PPV and iris reconstruction, there were no significant intraoperative or postoperative complications reported over the long-term follow-up. Moreover, the incidence of complications was far lower than those reported in earlier studies [ 4 , 5 , 10 – 13 ]. The mean postoperative BCVA was significantly improved compared with that before surgery (0.39 ± 0.56 logMAR vs. 0.89 ± 0.72 logMAR, p < 0.05).…”

“…The precise calculation of preoperative IOL power is critical, yet prior research indicates that postoperative refractive outcomes often bear a degree of unpredictability, with postoperative refractive states ranging from mild hyperopia to mild myopia. Retrospective analyses of sutureless intrascleral IOL fixation have yielded varied results; some studies report a myopic shift, while others indicate a hyperopic shift [4,5,10,[12][13][14][19][20][21]. In our study, the mean refractive difference from predicted value showed mild myopic shift (− 0.13 ± 0.42 D), aligning with the findings of Yamane et al Within our patient cohort, 63.6% exhibited a myopic shift, 36.4% a hyperopic shift, and notably, 63.6% achieved a target refractive error within 0.5 D.…”

Attaining the optimal flange technique for transscleral capsular bag stabilization using iris hooks

“…1 Flanging for scleral intraocular lens (IOL) fixation salvages the advantage of being less time-consuming and highly effective and showed to have satisfiable long-term outcomes. 2 Besides the secondary fixation of IOLs, a new technique for scleral stabilization of the capsular bag and IOL centration has been proposed by Karadag et al using 2 iris hooks sutured to the scleral bed. 3 This approach yields the advantage of preserving the capsular bag during surgery in cases with zonular dialysis or subluxated crystalline lenses.…”