Optical Quality Comparison Between Yamane Scleral-Fixated And In-The-Bag Intraocular Lenses Using Ray-Tracing Aberrometry: A Paired-Eye Study

To compare visual and optical quality between eyes with Yamane scleral-fixated intraocular lenses (IOLs) and fellow eyes with in-the-bag IOL implantation using objective ray-tracing aberrometry.

Akdeniz University Hospital, Turkey.

This comparative paired-eye study included 56 eyes of 28 patients operated between 2023 and 2025. Each patient had Yamane scleral-fixated IOL implantation in one eye (Group 1) and uneventful phacoemulsification with in-the-bag IOL implantation in the fellow eye (Group 2).

Measurements were obtained using the iTrace Visual Function Analyzer. Evaluated parameters included best-corrected visual acuity (BCVA), spherical equivalent (SE), total higher-order aberrations (HOA), coma, internal HOA, and quality of vision index (QVI).

The mean age was 69.7 ± 8.3 years.BCVA was significantly worse in Group1 compared to Group2 (0.75 ±0.84 vs 0.15 ±0.14 logMAR; p = 0.033). Spherical equivalent was comparable between the groups (–1.0 ±1.1 vs –0.49 ±0.82 D; p = 0.109).

Total HOA values were higher in Group 1, although the difference did not reach statistical significance (0.30 ± 0.35 vs 0.13 ± 0.06; p = 0.190). Coma aberration was significantly greater in Group 1 (0.19 ±0.24 vs 0.05 ±0.03; p = 0.013). Internal HOA values were also higher in Group 1, but the difference was not statistically significant (0.34 ±0.51 vs 0.11 ±0.06; p = 0.115). Quality of vision index was significantly lower in the Yamane group compared to the in-the-bag group (3.7 ±3.2 vs 6.6 ±1.9; p = 0.041).

Although refractive outcomes were comparable, Yamane scleral-fixated IOLs were associated with reduced visual quality and increased coma aberration compared to in-the-bag IOLs. Increased internal optical irregularities may contribute to decreased visual performance in scleral-fixated lenses