Novel yamane technique modification for haptic exposure after glued intrascleral haptic fixation

Gelman, Rachel; Garg, Sumit

doi:10.1016/j.ajoc.2019.03.009

Cited by 29 publications

(28 citation statements)

References 8 publications

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“…[ 11 ] Rachel Gelman described cauterization of the exposed haptic with a low-temperature cautery to create a bulb-shaped flange larger than the diameter of the haptic which can then be pushed back to lodge within the substance of the sclera. [ 12 ] This modified Yamane technique of haptic refixation seemed inappropriate in our cases as mismatch between the size of previous sclerotomy (20-gauage MVR, 1.1 mm) and the size of the flange (0.7 mm) carried risk of intraocular slippage of the haptic. Ohta's proposal of fixing the haptic to the scleral bed with a single 8–0 nylon suture to prevent its postoperative displacement predisposes it to risk of haptic malposition.…”

Section: Discussionmentioning

confidence: 96%

Scleral tunnel with conjunctival autograft for rescue management of extruded haptic

Agarwal

Todi

Bafna

et al. 2021

Indian Journal of Ophthalmology

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Extrusion of haptic is a rare complication after intra-scleral haptic fixation of intraocular lens (SF-IOL). Various techniques described for its management such as autologous scleral patch, cauterization of exposed haptic, reattempting the glued IOL and IOL explant have their own limitations. Presently, we describe a simple rescue technique for management of such situations. In this method, after performing localized conjunctival peritomy, 2 mm long partial-thickness scleral tunnel is fashioned with an angled 20-guage microvitreoretinal blade 1.5 mm away from the limbus in line with pre-existing defective scleral flap underneath which the exposed haptic is tucked securely. Following this, conjunctival autograft (CAG) with fibrin glue application is undertaken to combat conjunctival fibrosis. In three patients, where this technique was performed, had well-tucked haptic and maintained visual acuity with no complications at 3-months follow-up. This technique is a useful method of tucking extruded haptic after SFIOL in eyes subjected to multiple previous surgeries.

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Section: Discussionmentioning

confidence: 96%

Scleral tunnel with conjunctival autograft for rescue management of extruded haptic

Agarwal

Todi

Bafna

et al. 2021

Indian Journal of Ophthalmology

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“…This is striking as the sutureless sclera xation is expected to be prone to IOL tilt. 24 Long-term stability and complications pro le of the suture material was found to be better when thicker sutures were used. That is the reason why many surgeons switched from Prolene ® 10-0 to 9-0 and started using expanded polytetra uoroethylene (ePTFE) mono lament GoreTex CV-8 ® (thickness equals Prolene ® 7-0).…”

Section: Discussionmentioning

confidence: 96%

Safety and efficacy of current sclera fixation methods for intraocular lenses

Dr¹,

Wolf²,

Tc³

et al. 2021

Preprint

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Purpose Evaluation of currently three most-common intraocular lens (IOL) sclera fixation techniques (1) Prolene® suture with Hoffman sclera pocket (2) GoreTex® suture four-point technique (3) sutureless flanged intrascleral IOL fixation double-needle (“Yamane”) technique. Study design : Retrospective, clinical case series (chart review) conducted at the Department of Ophthalmology of the Ludwig-Maximilians-University, Munich, Germany. Methods Fifty-seven eyes of 53 patients were included. Best-corrected visual acuity (BCVA), manifest refraction (OR), corneal tomography, biometry, central macular thickness (CMT), intraocular pressure (IOP) were recorded and compared before and at least 20 days after IOL sclera fixation surgery. Results GoreTex® suture was done in 15, Prolene® in 20, Yamane technique in 22 eyes. The GoreTex® group showed 2, Prolene® 3, Yamane 1 eye that needed refixation due to visual impairment. Analysis between pre- and post-surgery revealed a statistically significant difference in the total BCVA (p = 0.002) and the Yamane subgroup BCVA (p = 0.047). There was no statistical difference between pre- and post-surgery IOP, CMT and CCT. No retinal complications were found. Surgery time with Yamane technique was about 1.5 times faster than GoreTex® and Prolene®. The surgery times of the subgroups differed statistical significantly. Regarding safety aspects of the three techniques no statistically significant difference pre- and post-surgery existed. Conclusion A visual rehabilitation to the status pre-surgery seems to be possible with a considerable amount of revision rates. All three analyzed techniques are a successful option in secondary IOL implantation in terms of efficacy and safety. The Yamane technique seems to be the least time-consuming surgical procedure.

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“…Unavoidable mild decentering of PC IOL was managed with appropriate refractive correction. e haptic tips were inside the tunnel to prevent foreign-body sensation or conjunctival erosion and reduce inflammation-causing stimuli [30].…”

Section: Discussionmentioning

confidence: 99%

Sutured Intrascleral Posterior Chamber Intraocular Lens Fixation with Ciliary Sulcus Location Guided by Ultrasonic Biological Microscopy: A Retrospective Analysis of Anatomical and Refractive Outcome

Duan

Huo

et al. 2020

Journal of Ophthalmology

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Purpose. To report the outcome of sutured intrascleral posterior chamber intraocular lens (PC IOL) fixation with ciliary sulcus location guided by ultrasonic biological microscopy (UBM). Methods. Patients who underwent a sutured intrascleral PC IOL fixation were reviewed and divided into four groups. In group 1, the traditional sulcus fixation (2 mm from limbus) of IOL was performed. In groups 2, 3, and 4, UBM was performed before surgery to locate the position of the ciliary sulcus as the haptics insertion position. IOL power was selected by decreasing the calculated value of the IOL power by 1.0 D, 1.0 D, 0.5 D, and 0.0 D, respectively. Results. Sixty-one patients (63 eyes) were included in the four groups. After 4.1 ± 3.0 months’ follow-up, the postsurgery spherical equivalent (SE) was 0.73 ± 1.86, 0.71 ± 0.84, 1.14 ± 0.45, and 0.07 ± 0.89 diopters (D), respectively. Statistical significance was reached for the postsurgery SE with target refraction between group 1 (p=0.027, <0.05), group 2 (p=0.003, <0.01), and group 3 (p=0.017, <0.05). No significant difference existed for the postsurgery SE with target refraction in group 4 (p=0.779, >0.05), and the postsurgery SE in group 4 was the nearest to target refraction. Conclusion. Intrascleral PC IOL fixation guided by UBM is helpful for locating the ciliary sulcus and satisfactory visual outcomes with a predictable IOL power calculation.

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Novel yamane technique modification for haptic exposure after glued intrascleral haptic fixation

Cited by 29 publications

References 8 publications

Scleral tunnel with conjunctival autograft for rescue management of extruded haptic

Scleral tunnel with conjunctival autograft for rescue management of extruded haptic

Safety and efficacy of current sclera fixation methods for intraocular lenses

Sutured Intrascleral Posterior Chamber Intraocular Lens Fixation with Ciliary Sulcus Location Guided by Ultrasonic Biological Microscopy: A Retrospective Analysis of Anatomical and Refractive Outcome

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