Novel surgical technique of sutureless artificial iris and intraocular lens scleral fixation using Yamane technique

Dr, Muth; Sg, Priglinger; Shajari, Mehdi; Tc, Kreutzer; Wj, Mayer

doi:10.1016/j.ajoc.2022.101502

Cited by 3 publications

(4 citation statements)

References 48 publications

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“…The mainstay of the presented technique is the “Sandwich” or “Backpack” AI implantation in which the IOL is sutured to the back of the AI using the IOL haptics and inserted into the eye as a folded sandwich [ 9 ]. The advantages of this technique are the small surgical incision due to a foldable AI–IOL package and minimal additional trauma, as most of the surgery takes place outside the eye.…”

Section: Discussionmentioning

confidence: 99%

Custom-Made Artificial Iris and Toric-Intraocular Lens Intrascleral Flange Fixation: A Case Report

Moshkovsky,

Megiddo-Barnir,

Kleinmann

2024

Medicina

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Different techniques for artificial iris implantation with or without an intraocular lens, depending on lens status, are described in the literature. We describe a surgical technique for a custom-made artificial iris and toric-intraocular lens intrascleral flange fixation. We modified the “Backpack” artificial iris implantation surgical technique to facilitate an accurate alignment of the toric-intraocular lens in a patient with aphakia, aniridia, and high asymmetric astigmatism secondary to blunt trauma. Two months after the surgery, uncorrected visual acuity was 20/30, corrected to 20/25 with a refraction of −2.00 in the diopter sphere with no residual astigmatism. The artificial iris implant and toric-intraocular lens were well-centered. The patient was satisfied with the visual and cosmetic outcomes. This procedure, however, is not complication-free as our patient developed uveitis and increased intraocular pressure during the postoperative period, which was treated successfully.

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Section: Discussionmentioning

confidence: 99%

Custom-Made Artificial Iris and Toric-Intraocular Lens Intrascleral Flange Fixation: A Case Report

Moshkovsky,

Megiddo-Barnir,

Kleinmann

2024

Medicina

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“…A more novel approach that has been used with these implants in patients who are aphakic is the "sandwich technique" where a three-piece IOL is fixed to the back of the artificial iris implant using the IOL haptics [54]. Penetration sites (for the IOL haptics) are marked 1 mm away from the outer iris implant rim at 0 and 180 degrees.…”

Section: Customizable Artificial Irismentioning

confidence: 99%

Iris Reconstruction: A Surgeon’s Guide

Ferro Desideri,

Arun,

Doherty

et al. 2024

JCM

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Objectives: The aim of this review paper is to summarise surgical options available for repairing iris defects at the iris–lens plane, focusing on suturing techniques, iridodialysis repair, and prosthetic iris devices. Methods: A thorough literature search was conducted using multiple databases, including Medline, PubMed, Web of Science Core Collection, and the Cochrane Library, from inception to February 2024. Relevant studies were screened based on predefined criteria, and primary references cited in selected articles were also reviewed. Results: Various surgical techniques were identified for iris defect repair. Suturing methods such as interrupted full-thickness sutures and the McCannel technique offer solutions for smaller defects, while iridodialysis repair techniques address detachment of the iris from the ciliary body. Prosthetic iris devices, including iris–lens diaphragm devices, endocapsular capsular tension ring-based devices, and customizable artificial iris implants, provide options for larger defects, each with its own advantages and limitations. Conclusions: Successful iris reconstruction requires a personalised approach considering factors like defect size, ocular comorbidities, and patient preference. Surgeons must possess a thorough understanding of available techniques and prosthetic devices to achieve optimal outcomes in terms of both visual function and, nonetheless, cosmetic appearance.

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“…T he flanged intrascleral intraocular lens (IOL) fixation with the double-needle technique was introduced in 2017 by Yamane et al and has been widely used for aphakia correction without capsular support of different etiologies. [1][2][3][4] Some modifications of the original approach have been described. [5][6][7] The essential steps of the technique are the formation of a precise needle-made trans-scleral tunnel, haptic-to-needle docking, haptic externalization, and haptic flanging with heat.…”

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confidence: 99%

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confidence: 99%

Size variability and fitting of 30-gauge thin-wall needles and 3-piece intraocular lens haptics for the flanged intrascleral fixation technique

Pukl

Kronschläger

Ruiss

et al. 2023

J Cataract Refract Surg

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Purpose: To assess the diameter of different 30-gauge thin-wall needles and 3-piece intraocular lens (IOL) haptics readily used for the flanged-haptic intrascleral fixation technique. Setting: Hanusch Hospital, Vienna, Austria. Design: Laboratory investigation. Methods: 5 30-gauge thin-wall needles and 5 3-piece IOLs were assessed. An upright light microscopy was used for measurements. The inner and outer diameters of the needles and the end thickness of the haptics were analyzed and compared for haptic fitting into the needle. Results: Among the needles, the inner diameter of the T-lab needle was significantly wider compared with all the others (mean 209.3 ± 8.0 μm, P < .001), followed by TSK (194.8 ± 5.0 μm), MST (194.7 ± 5.8 μm), Sterimedix (187.5 ± 9.0 μm) and significantly narrower Meso-relle (mean 178.7 ± 7.0 μm, P < .05). The outer diameter of the T-lab needle was significantly larger of all (mean 316.0 ± 2.0 μm, P < .001). Concerning the IOLs, the AvanseePreset Kowa's haptic was significantly thinner (mean 127.2 ± 0.7 μm) than all the others, such as the TecnisZA900 Johnson & Johnson (143.5 ± 3.1 μm), the CTLucia202 Zeiss (143.8 ± 1.3 μm), and the AcrysofMA60AC Alcon (143.9 ± 1.4 μm). The only haptic that was thicker than all the others assessed was that of SensarAR40 Johnson & Johnson (170.7 ± 1.7 μm, P < .001). Conclusions: Most of the analyzed haptics would fit into most of the measured needles, with the exception of the Sensar AR40 in combination with the Meso-relle or Sterimedix needles. The combination of a larger needle lumen and a thinner haptic could result in more ease of insertion during surgery. If the dimensions of the needle and IOL haptics used are unknown, we recommend trying insertion before beginning surgery.

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Novel surgical technique of sutureless artificial iris and intraocular lens scleral fixation using Yamane technique

Cited by 3 publications

References 48 publications

Custom-Made Artificial Iris and Toric-Intraocular Lens Intrascleral Flange Fixation: A Case Report

Custom-Made Artificial Iris and Toric-Intraocular Lens Intrascleral Flange Fixation: A Case Report

Iris Reconstruction: A Surgeon’s Guide

Size variability and fitting of 30-gauge thin-wall needles and 3-piece intraocular lens haptics for the flanged intrascleral fixation technique

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