Secondary intraocular lens implantation with Yamane double needle technique in patients with corneal stromal scarring

Abstract

Purpose

To evaluate the efficacy/complications of Yamane double needle technique and when needed following penetrating keratoplasty (PKP) in cases with corneal stromal scarring.

Setting

Ege University Hospital, Department of Ophthalmology, Izmir.

Design

Retrospective Cohort Study.

Methods

Yamane double needle technique was applied to patients with corneal stromal scarring. Pre/post-operative best corrected visual acuity (BCVA-logMAR), intraocular pressure (Goldmann), detailed anterior and posterior segment examinations with slit-lamp, ultrasonography and optic coherence tomography were performed.

Results

The technique was applied to 24 eyes of 24 patients. Mean age was 57.33 ± 16.71(13–79) years. Male/female ratio was 0.5. Following secondary intraocular lens implantation with Yamane technique mean best corrected visual acuity improved significantly (1.66 ± 0.44 vs 1.15 ± 0.71 logMAR; p = 0.002). After the implantation transient intraocular pressure elevation (4 eyes [16%]), hyphema (2 eyes [8%]), cystoid macular edema (2 eyes [8%]), vitreous hemorrhage (1 eye [4%]), granulomatous uveitis recurrence (1 eye [4%]), intraocular lens dislocation (1 eye [4%]) were observed. PKP was performed to 9 eyes (37%). Due to improvement in BCVA corneal transplantation was postponed in 11 eyes (0.83 ± 0.61 logMAR). The eyes which had undergone penetrating keratoplasty had a mean BCVA of 1.68 ± 0.53 logMAR) which improved after surgery (1.01 ± 0.58 logMAR; p = 0.028). Following penetrating keratoplasty, intraocular pressure elevation (3 eyes [12%]), cystoid macular edema (2 eyes [8%]), hypotonia (2 eyes [8%]), epithelial defects (2 eyes [8%]), keratitis (1 eye [4%]) were detected.

Conclusion

Yamane double needle technique is a safe and an effective method for visual rehabilitation in eyes with aphakia or insufficient capsular support accompanied by corneal stromal scarring. PKP can be performed safely as a stepwise approach after Yamane double needle technique. Moreover, in some patients due to visual improvement corneal transplant might be postponed.