目的：对比无足够囊膜支撑的无晶状体眼患者，分别采用改良Yamane技术与Z缝合术式行巩膜固定人工晶状体(IOL)植入术后的视力预后、屈光可预测性及并发症发生率。

方法：本回顾性研究纳入了2017至2024年间接受巩膜固定IOL植入术的无晶状体眼患者。将患者分为两组：第1组接受改良Yamane术式，第2组则采用Z缝合术式。评估指标包括最佳矫正视力(BCVA，LogMAR)、等效球镜(SE)、柱镜误差(CE)、角膜散光(CA)、平均绝对误差(MAE)及术后并发症。

结果：本研究共纳入101例无晶状体眼患者，平均年龄72.6±10.7岁。第1组纳入男22例，女19例，平均年龄72.1±11.0岁，第2组纳入男35例，女25例，平均年龄73.0±10.5岁。术后1 mo，第一组BCVA显著优于第2组，分别为0.49±0.21， 0.66±0.17 LogMAR，P=0.02。术后6 mo，两组BCVA差异无统计学意义，分别为0.38±0.19与0.41±0.20 LogMAR，P>0.05。各随访时间点的组间SE、CE及CA均无统计学差异(均P>0.05)。第1组术后1 mo(0.72±0.80 vs 0.80±0.64 D)和6 mo(0.63±0.41 vs 0.72±0.33 D)的MAE均略低于第2组，但无统计学意义(P>0.05)。两组总体并发症发生率相近； 但襻脱位在Yamane 术式组发生率显著更高(P=0.025)。

结论：改良Yamane技术与Z缝合术式均为无足够囊膜支撑的无晶状体眼进行二期IOL植入术的安全有效选择。Yamane术式在短期内表现出更快的视力恢复和略优的屈光可预测性，而两种方法的长期结果相当。

METHODS:This retrospective study included aphakic patients who underwent scleral-fixated IOL implantation between 2017 and 2024. Patients were divided into two groups: Group 1 received the modified Yamane technique, while Group 2 underwent fixation using the Z-suture technique. Best-corrected visual acuity(BCVA, LogMAR), spherical equivalent(SE), cylindrical error(CE), corneal astigmatism(CA), mean absolute error(MAE), and postoperative complications were assessed.

RESULTS:Totally 101 aphakic patients(mean age 72.6±10.7 y)were included. Group 1 included 22 males and 19 females, with a mean age of 72.1±11.0 y. Group 2 included 35 males and 25 females, with a mean age of 73.0±10.5 y. At 1 mo postoperatively, the BCVA in Group 1 was significantly better than that in Group 2, 0.49±0.21 vs 0.66±0.17 LogMAR, P=0.02. By month 6, BCVA was comparable between groups(0.38±0.19 vs 0.41±0.20 LogMAR, P>0.05). No statistically significant differences were observed in SE, CE, or CA at any time point(all P>0.05). MAE was slightly lower in Group 1 at both 1(0.72±0.80 vs 0.80±0.64 D)and 6 mo(0.63±0.41 vs 0.72±0.33 D), although these differences were not statistically significant(P>0.05). Overall complication rates were similar; however, haptic dislocation was significantly more common in the Yamane group(P=0.025).

CONCLUSION:Both the modified Yamane and Z-suture techniques are safe and effective options for secondary IOL implantation in aphakic eyes lacking adequate capsular support. The Yamane technique demonstrates faster visual recovery and slightly improved refractive predictability in the short term, while long-term outcomes are comparable between the two methods.