Surgical Outcomes And Complications Following Sutureless Intrascleral Intraocular Lens Fixation – 7 Year Experience With The Yamane Technique

To evaluate the surgical outcomes and complications following sutureless intrascleral intraocular lens(IOL) fixation using the Yamane technique.

LEC Eye Centre, Ipoh, Malaysia

Retrospective study of 108 eyes of 100 patients who underwent intrascleral IOL fixation with the Yamane technique by a single surgeon. Primary indications for surgery, best corrected visual acuity(BCVA), refractive outcomes, complications and duration of follow up were analysed. All visual acuities were converted to logarithm of minimal angle of resolution(logMAR) for analysis.

The primary indications for surgery were aphakia(11.1%), intraoperative posterior capsular rupture or zonulysis(16.7%), dislocated IOL(58.3%) or cataract(11.1%), opacified IOL(1.8%) and corneal decompensation(0.9%). The mean preoperative BCVA was 0.89+0.79 which improved to 0.37+0.50 with a mean follow up of 15.9+15.1 months. The mean refractive spherical equivalent(MRSE) was -0.10+1.00D with 57.3% and 79.2% of eyes within 0.5D and 1D of target refraction respectively. Complications include bullous keratopathy(2.8%), secondary glaucoma(4.6%), cystoid macular oedema(1.8%), vitreous haemorrhage(0.9%), retinal detachment(0.9%), uveitis(5.5%), IOL malposition(5.5%) and haptic extrusion(1.8%). 

Sutureless IOL fixation with the Yamane technique showed good visual outcomes and is a safe technique with a low incidence of complications. There is an associated learning curve as all complications recorded occurred during the surgeon’s first 30 cases.