The Effect Of Horizontal Visible Iris Diameter On Refractive And Optical Outcomes After Scleral Fixation Intraocular Lens Implantation With Yamane Technique
Published 2026 - 44th Congress of the ESCRS
Reference: FP24.12 | Type: Free paper | DOI: 10.82333/g863-fv16
Authors: Dr Kubra Caglar* 1 , A/Prof. Burcu Kemer Atik 1 , Prof. Dr Ahmet Kırgız 1 , A/Prof. Nilay Kandemir Besek 1 , A/Prof. Sibel Ahmet 1
1Ophthalmology,Beyoglu Eye Training and Research Hospital,Istanbul,Türkiye
Purpose
To evaluate whether horizontal visible iris diameter (HVID) affects refractive predictability and internal optical quality after scleral fixation performed with a standardized 2.5 mm scleral distance using the Yamane technique.
Setting
Retrospective comparative study conducted at a tertiary eye care center in Istanbul, Turkey.
Methods
54 eyes undergoing Yamane scleral-fixated intraocular lens (IOL) implantation were included, and all procedures were performed by a single experienced surgeon.In all cases, haptics were brought out 2.5 mm posterior to the limbus. HVID was measured using a Scheimpflug imaging system (Sirius, CSO, Florence, Italy), and eyes were divided into group 1 (<11.30 mm, n=24) and group 2 (≥11.30 mm, n=30). The values of uncorrected visual acuity(UCVA) and best corrected visual acuity(BCVA) were obtained from patients medical records. Refractive error, internal astigmatism, and internal higher-order aberrations(HOAs) (coma, trefoil, and spherical aberration) were measured using a ray-tracing aberrometer (iTrace, Tracey Technologies, Houston, TX, USA).
Results
Postoperative spherical and cylindrical values were higher in group1 than group2 (1.58 ±1.19 D vs 0.93 ± 0.96 D, p=0.030; 2.70 ±1.44 D vs 1.41 ± 0.79 D, p<0.001, respectively). UCVA was better in group2 (0.38 ± 0.35 vs 0.41 ± 0.25 LogMAR, p =0.013), whereas BCVA was similar in two groups (0.18 ± 0.19 vs 0.41 ± 1.66 LogMAR, p=0.152).
Internal astigmatism was higher in group1 (0.44 ± 0.33 µm vs 0.30 ± 0.22 µm, p=0.047).Total internal HOAs and trefoil were also higher in group1 (p= 0.011 and p=0.025), while coma and spherical aberration were similar in two groups (p=0.361 and p=0.787).
HVID demonstrated negative correlations with cylindrical values (r=−0.484, p< 0.001), total internal HOAs (r= −0.353, p=0.009), and trefoil (r= −0.297, p=0.029).
Conclusions
Smaller HVID (<11.30 mm) seems to be associated with larger postoperative refractive error, higher residual astigmatism, and increased HOAs after Yamane scleral fixation IOL implantation. Therefore, preoperative HVID measurement can help improve refractive predictability and surgical planning in these cases.