A Minimalistic Approach To The Modified Yamane Technique Scleral Fixated Intra-Ocular Lens-- Safer, Faster, More Economical And Consistently Reproducible Good Outcomes, With No Infusion Line Or Special Instruments Required.

To share surgical technique of performing a modified Yamane Technique sutureless scleral fixated intraocular lens (IOL) with a faster, safer, more economical minimalistic approach, without the use of infusion line and/or any special instruments. It is hoped that this simplified modified technique can give more inspiration and confidence for more ophthalmologists to perform, thus benefitting more patients world-wide. 

This technique is performed in a standard cataract set-up operating theatre (OT) with the availability of a standard cataract surgical set, a hand-held low temperature cautery, two 26G x 12mm needles and a Sensar AR40e IOL suitable for a particular patient. It can be applicable to aphakic patients. This technique can also be applied in the same setting during the course of a primary cataract surgery when capsular support is lost, thereby minimising OT time and avoiding a secondary operation.

In the aphakic eye, standard Yamane Technique ocular surface markings are done. Two 26G x 12mm needles are introduced at 180 degrees apart at the medial and lateral aspect of the sclera 2mm behind the limbus. A 2.8mm keratome shelfed incision is done superiorly. Viscoelastic is then filled in the anterior chamber (AC). The three-piece IOL is slowly introduced into the AC. When the tip of the leading haptic is visible from the lens injector bevel, hand-shake technique is used to directly engage with the pre-placed needle, and with a tying forceps, trailing haptic is guided to engage with the other needle. Then both haptics are externalised and flanged with low-temperature hand-held cautery. No additional intruments required. 

By using the above described technique, the time taken to implant and flange the externalised haptics is usually less than 5 minutes. Consistent reproducible results whereby the IOL is successfully fixed using the above-mentioned method, in the desired central position and achieving a good visual acuity post-operatively is achieved, without the need of an infusion line and/or any other special instruments such as the vitreo-retinal micro-forceps.

The minimalistic approach Yamane Technique scleral fixated IOL, without infusion line and no need for special instruments such as vitreo-retina micro-forceps (which may not be readily available, and possibly costly) can be performed safely, efficiently, economically and consistently with good post-operative outcome. This technique can be applied to patients who are aphakic and also to situations during the primary cataract operation when the capsular support is lost-done in the same sitting, thereby avoiding a secondary operation. It is hoped that this simplified minimalistic modified technique can give more inspiration and confidence for more ophthalmologists to perform, thus benefitting more patients world-wide.