Abstract:AIM:To compare the visual outcomes, refractive predictability, and complication rates associated with scleral-fixated intraocular lens(IOL)implantation using the modified Yamane and Z-suture techniques in aphakic patients lacking adequate capsular support.
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.
