Sage Journals: Discover world-class research

Abstract

Purpose

To compare the modified Yamane (MY) technique with the modified double-flange (MDF) technique in the management of subluxated single-piece foldable intraocular lenses (IOLs).

Methods

This retrospective study was conducted on 29 eyes (group MY:17 eyes, group MDF:12 eyes). In both techniques, the subluxated IOLs were moved to the anterior chamber, and anterior vitrectomy was performed. In group MY, the IOL was extracted using an approach similar to the “twist-and-out” technique without enlarging the main incision.The surgery was performed by creating a scleral tunnel 2.5 mm posterior to the limbus using a 26-gauge injector.In group MDF,a 6.0 polypropylene suture was passed through the widest part of the haptic near the optical portion using a 27-gauge injector guide. Visual, refractive results and complications of the two groups were compared.

Results

Both groups exhibited significant improvement in corrected distance visual acuity.No differences were observed between the groups in terms of spherical refraction, spherical equivalent, surgical time, or intraocular pressure values (p > 0.05 for all). Cylindrical refraction was −1.21 ± 0.14 D in group MY and −1.76 ± 0.25 D in group MDF(p = 0.03).The pseudophacodonesis score was 0.45 ± 0.15 in group MY compared to 1.21 ± 0.55 in group MDF (p < 0.001).Central macular thickness was similar between the two groups preoperatively, while at 6 months postoperatively, it measured 251 ± 15 μm in group MY and 274 ± 18 μm in group MDF (p = 0.19 and p = 0.01).

Conclusion

To our knowledge, this study is the first to compare the MY and MDF techniques for subluxated IOLs. Both techniques showed similar efficacy and safety. However, group MY demonstrated better and more stable IOL centration.

Keywords

Complicated cataract modified double-flange technique modified Yamane technique subluxated intraocular lens

Get full access to this article

View all access options for this article.

References

Mönestam

. Incidence of dislocation of intraocular lenses and pseudophakodonesis 10 years after cataract surgery. Ophthalmology 2009; 116: 2315–2320.

Tran

THC

Zaier

Proença

, et al. Posterior segment intra-ocular implant (IOL) dislocation: predisposing factors, surgical management, outcome analysis. J Fr Ophtalmol 2020; 43: 1062–1068.

Gimbel

Condon

Kohnen

, et al. Late in-the-bag intraocular lens dislocation: incidence, prevention, and management. J Cataract Refract Surg 2005; 31: 2193–2204.

Pueringer

Hodge

Erie

. Risk of late intraocular lens dislocation after cataract surgery, 1980-2009: a population-based study. Am J Ophthalmol 2011; 152: 618–623.

Dajee

Abbey

Williams

. Management of dislocated intraocular lenses in eyes with insufficient capsular support. Curr Opin Ophthalmol 2016; 27: 191–195.

Matsumoto

Yamada

Uematsu

, et al. Spontaneous dislocation of in-the-bag intraocular lens primarily in cases with prior vitrectomy. Eur J Ophthalmol 2012; 22: 363–367.

Yamane

Sato

Maruyama-Inoue

, et al. Flanged intrascleral intraocular lens fixation with double-needle technique. Ophthalmology 2017; 124: 1136–1142.

Canabrava

Carvalho

. Double-flanged polypropylene technique: 5-year results. J Cataract Refract Surg 2023; 49: 565–570.

Samir

ElHag

Elsayed

AMA

, et al. Scleral fixation of single-piece foldable IOL using double-flanged technique. Clin Ophthalmol 2020; 14: 3131–3136. doi:https://doi.org/10.2147/OPTH.S276226

10.

Błagun

Krix-Jachym

Rękas

. Comparison of safety and efficacy of four-point scleral intraocular Lens fixation and the Yamane technique. Ophthalmol Ther 2024; 13: 1955–1966.

11.

Sahin Vural

Guven

Karahan

, et al. Long term outcomes of Yamane technique in various indications. Eur J Ophthalmol 2023; 33: 2210–2216.

12.

Boz

AAE

Atum

Özmen

, et al. Comparison of three different intraocular lens implantation techniques in the absence of capsular support: sutured scleral, haptic flanged intrascleral, and four flanged intrascleral fixations. Int Ophthalmol 2023; 43: 5045–5053.

13.

Kelkar

Kothari

, et al. Comparison of two modified sutureless techniques of scleral fixation of intraocular Lens. Ophthalmic Surg Lasers Imaging Retina 2018; 49: e129–e134. doi:https://doi.org/10.3928/23258160-20181002-15

14.

Shekhawat

Goyal

. Sutureless glueless intrascleral fixation of posterior chamber intraocular lens: boon for aphakic. Indian J Ophthalmol 2017; 65: 1454–1458. doi:https://doi.org/10.4103/ijo.IJO_620_17

15.

Kawaji

Sato

Tanihara

. Sutureless intrascleral intraocular lens fixation with lamellar dissection of scleral tunnel. Clin Ophthalmol 2016; 10: 227–231. doi:https://doi.org/10.2147/OPTH.S101515

16.

Zhang

Jiang

, et al. Modified technique for intrascleral fixation of posterior chamber intraocular lens without scleral flaps. J Cataract Refract Surg 2017; 43: 162–166.

17.

Sinha

Bansal

Sharma

, et al. Transscleral suture-fixated versus intrascleral haptic-fixated intraocular Lens: a comparative study. Eye Contact Lens 2017; 43: 389–393.

18.

Todorich

Stem

Kooragayala

, et al. Structural analysis and comprehensive surgical outcomes of the sutureless intrascleral fixation of secondary intraocular lenses in human eyes. Retina 2018; 38: S31–S40.

19.

Pandit

Devgan

Chapman

Jr . Twist and out intraocular lens removal. J Cataract Refract Surg 2020; 46: 1072–1074.

20.

Goemaere

Trigaux

Denissen

, et al. Fifteen years of IOL exchange: indications, outcomes, and complications. J Cataract Refract Surg 2020; 46: 1596–1603.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB