Comparative Evaluation Of Corneal Aberrations And Anterior Segment Parameters In Intraocular Lens Surgery Using A Capsular Tension Ring Versus The Yamane Technique

This study aimed to comparatively evaluate the effects of two different intraocular lens implantation techniques—Yamane technique (YT) and capsular tension ring–assisted intraocular lens implantation (CTRIOL)—performed during or following complicated cataract surgery, on anterior segment parameters and corneal aberrations.

The patients undergoing YT, CTRIOL, monofocal intracapsular IOL (ICIOL) implantation were included in the study. The patients' preoperative best-corrected visual acuity (BCVA), spherical and cylindrical refraction, corneal cylindrical refraction (Astigmatism), anterior chamber depth (ACD), axial length, intraocular pressure (IOP), endothelial cell density (CD), and central pachymetry (CCT) values were recorded. The patients' postoperative 3-month BCVA, spherical and cylindrical refraction, corneal and lenticular astigmatism, IOP, CCT, CD, corneal high-order (HOA) and spherical aberration (SA), scotopic and photopic pupillometry values were recorded. These parameters were compared between the groups and the pre-postoperative periods.

A total of 56 patients were included (20 ICIOL, 17 YT, and 19 CTRIOL), with a mean age of 67.0 ± 10.9 years. Postoperative BCVA was highest in the ICIOL and lowest in the YT group (p=0.022). Preoperative ACD was greatest in YT (p=0.014), while postoperative CD was lowest in YT (p=0.014). Postoperative IOP and CCT were highest in YT, followed by CTRIOL. Corneal astigmatism was significantly higher in YT (p=0.031), whereas lenticular astigmatism showed no intergroup differences. HOA levels were lowest in ICIOL and highest in YT (p=0.001). SA was lowest in ICIOL and highest in CTRIOL (p=0.001). Photopic pupil diameter was highest in YT and lowest in ICIOL, while scotopic pupil diameter was highest in ICIOL and lowest in YT (p=0.001).

In conclusion, the findings of this study suggest that the YT may have a less favorable effect on certain anterior segment parameters and postoperative BCVA when compared with CTRIOL implantation. Although both techniques provided satisfactory anatomical and functional outcomes, the YT group demonstrated comparatively greater alterations in anterior segment configuration. The two surgical approaches demonstrate differential effects on optical quality; corneal HOAs were more pronounced following the YT, whereas corneal SA was higher in the CTRIOL group. Furthermore, the observed alterations in pupillary dynamics indicate that the YT may exert a greater adverse effect on pupillary muscle function.