Flapless and Sutureless Intrascleral Fixation of Posterior Chamber Intraocular Lens for Correction of Aphakia in Absence Of Capsular Support

Abstract

Purpose: This study aimed to assess safety and efficacy of flapless and sutureless intrascleral fixation of Posterior chamber intraocular lens (PC IOL) (Modified Yamane technique). Patients and methods: This is a prospective, non comparative, interventional case series study included 20 eyes with aphakia, dislocated IOL, or subluxated crystalline lens who underwent sutureless and flapless implantation of a PC IOL. Results: Our study shows an improvement in uncorrected distance visual acuity (UCDVA) and corrected distance visual acuity (CDVA) that was maintained till the end of follow up period. Mean UCDVA and Mean CDVA improved to 0.4 and 0.3 LogMAR units respectively. Mean spherical equivalent was reduced from 10.4 preoperatively to -0.57 six months postoperatively. Corneal endothelial cell count (ECC) was reduced from 2062 ± 546 cells/mm² preoperatively to 1853 ± 618 cells/mm² 6 months postoperatively. The median IOL-induced astigmatism was -0.75. IOL decentration was noticed in five eyes (25%) and significant IOL tilt was noticed in two eyes (10%). The postoperative complication included transient increase in IOP in five eyes (25%), hypotony and choroidal detachment in one eye (5%), iris capture of lens optic in only one eye (5%), Non buried flange in three eyes (15%), Cystoid macular edema (CME) in one eye (5%).Conclusion: Yamane technique is an elegant method for Intrascleral haptic fixation (ISHF) with a new strategy of securing haptics to sclera, by melting haptics to create a flange. It carried out favourable surgical outcome and limited post operative complications.