A Prospektive Randomised Trial Comparing The Yamane And The 4-Flanged Technique

A prospective comparison of the two most commonly used techniques for scleral fixation of intraocular lenses (IOLs) with respect to postoperative outcomes.

Monocentric, prospective, randomized comparative study at the Medical University of Vienna

Patients with subluxated IOLs or absent capsules without other vision-impairing comorbidities were consecutively enrolled in this study. A baseline ophthalmological examination, biometric measurements, and optical coherence tomography (OCT) of the anterior segment and macula (AS/OCT) were performed at the beginning of the study. Patients were randomized into either the Yamane group (YG) or the 4-flanged group (4FG). Follow-up visits with visual acuity measurements, AS-OCT, and OCT were scheduled at 1, 4, and 12 weeks postoperatively. Mixed linear models were used for statistical comparison between the groups and over time.

A total of 50 patients were included, with a significant increase in visual acuity to 0.8 Snellen at visit 4 in both groups compared to baseline (p<0.05). Regarding postoperative IOL tilt and decentration, no differences were observed between visits within the groups (p=0.949). At all visits, the 4FG group showed a lower tilt of 5.4° (95% CI: 3.6–7.1) compared to the Yamane group, which showed a tilt of 8.33° (95% CI: 6.69–9.98) (p=0.17). IOL decentration was comparable in both groups, with the YG at 0.58 mm and the 4FG at 0.56 mm (p=0.89). There was no significant difference in the incidence of cystoid macular edema (CME) between the groups (YG: 2 patients, 4FG: 4 patients) (p=0.412).