A modified Yamane technique with a posterior approach in a case report of intraocular lens dislocation

The Yamane intrascleral fixation technique is a widespread surgical approach used in ophthalmology to secure three-piece intraocular lenses (IOLs) without the use of sutures. This technique is particularly beneficial in cases where the capsular bag is not suitable for IOL implantation. By creating a flange at the tip of each haptic this procedure innovatively eliminates the need for additional securing materials. We report an alternative management of posterior intraocular lens (IOL) dislocation with a modified Yamane technique, performed in vitreous chamber.

We describe the surgery of a 56-year-old male with posterior dislocation of the capsular bag and a three-piece IOL with Polymethylmethacrylate (PMMA) loops into the vitreous cavity. His medical history included retinal detachment treated with scleral buckling 40 years earlier and cataract surgery performed 4 years earlier. The patient underwent a 25-gauge pars plana vitrectomy. Scleral tunnels were created to externalize the PMMA loops and securing the IOL in a stable position according to the classic Yamane technique: a bimanual approach with a 30-gauge x 13 mm ultra-thin-walled needle and maxgrip forceps was used.

Modified Yamane technique performed in vitreous chamber, especially in selected cases of dislocated IOL with PMMA loops, may allow better handling of the IOL and the loop insertion. This modified technique, by reducing mechanical stress on the PMMA loops, contributes to long-term IOL integrity and lowers the risk of complications during surgery.

This technique may offer a reliable alternative for ophthalmic surgeons managing PMMA IOLs dislocations.