Intraocular Lens Stability And Refractive Outcomes After Modified Yamane Intrascleral Fixation, With Or Without Endothelial Keratoplasty.
Published 2026 - 44th Congress of the ESCRS
Reference: PP15.017 | Type: Free paper | DOI: 10.82333/4pj3-6121
Authors: Dr Kouichi Igarashi* 1 , Dr Sawako Koutari 1 , Dr Tadashiro Saeki 1 , Prof. Dr Satoru Yamagami 1 , Dr Takahiko Hayashi 1
1Ophthalmology,Nihon University Itabashi Hospital,Tokyo,Japan
Purpose
To evaluate intraocular lens stability, and to identify factors affecting post-operative refractive errors following modified Yamane suture-less intrascleral fixation, with or without combined endothelial keratoplasty (EK) .
Setting
This retrospective study was conducted with the approval of the Clinical Research Ethics Committee of Nihon University Itabashi Hospital (approval number RK-250311-3),and in accordance with the principles of the Declaration of Helsinki.
Methods
Patients undergoing intraocular lens (IOL) intrascleral fixation for aphakia, lens subluxation, or IOL dislocation were included, with or without endothelial keratoplasty (EK), including Descemet’s stripping automated endothelial keratoplasty or Descemet membrane endothelial keratoplasty.
Collected data included age, sex, axial length, refraction, corneal endothelial cell density, best-corrected visual acuity, intraocular pressure, and aqueous depth (AQD), tilt, and decentration measured by anterior segment optical coherence tomography (ASOCT; CASIA2). IOL power was calculated using the Barrett Universal II formula with the IOLMaster.
AQD was defined as the distance between the posterior corneal surface and anterior IOL surface (Figure 1A).
Results
Forty-one eyes were included: 21 in the endothelial keratoplasty(EK) group and 20 control group (mean age 70.9±14.2 years).
Preoperatively, significant differences were found in age (higher in EK group; p=0.006), IOL power (p=0.025), axial length (shorter in EK group; p=0.049), additional procedures (p=0.016), and logMAR BCVA (worse in EK group; p<0.001). Postoperatively, BCVA remained worse in EK group (p<0.001).
No significant differences were observed in spherical equivalent (p=0.321), refractive error (p=0.540), tilt (p=0.067), decentration (p=0.284), or AQD (p=0.088). Refractive error showed mild hyperopic shift in EK group (0.45±2.08 D vs −0.13±1.41 D; p=0.540). Greater IOL tilt tended in EK group(9.03±6.77° vs 5.57±3.35°; p=0.067).
Conclusions
Combined endothelial keratoplasty (EK) did not significantly compromise IOL centration or refractive stability after modified Yamane fixation. However, careful surgical planning may be required in complex cases requiring EK.