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Late Reverse Pupillary Block After Scleral Fixation With Yamane Technique: A Case Report
Maria J Chaves-Samaniego1,2, Gunjan Awatramani2, Nazimul Hussain1
1Ophthalmology Department, Mediclinic Parkview Hospital, Dubai, UAE.
Case Reports in Ophthalmological Medicine
|December 31, 2025
Summary
Late complications of the Yamane technique, a sutureless intraocular lens (IOL) fixation, can include reverse pupillary block and recurrent IOL subluxation. Careful surgical technique and patient selection are crucial for minimizing risks.
Area of Science:
- Ophthalmology
- Surgical Techniques
- Intraocular Lenses
Background:
- The Yamane technique offers sutureless scleral fixation of intraocular lenses (IOLs) for eyes lacking capsular support.
- While generally safe and effective, rare late complications like IOL subluxation have been documented.
Purpose of the Study:
- To describe a rare case of late-onset reverse pupillary block and recurrent IOL subluxation after Yamane fixation.
- To identify potential contributing factors and emphasize preventative measures.
Main Methods:
- Presentation of a clinical case involving a 64-year-old male who underwent Yamane IOL fixation.
- Details of surgical interventions including pars plana vitrectomy and IOL repositioning.
- Analysis of intraoperative findings and long-term follow-up.
Main Results:
- The patient developed cystoid macular edema, a macular hole, and iris capture with pupillary block five years post-Yamane fixation.
- Multiple episodes of IOL subluxation occurred, necessitating repeated repositioning and laser iridotomy.
- IOL stability was achieved at 18-month follow-up after final repositioning, with controlled intraocular pressure.
Conclusions:
- This case underscores the potential for late reverse pupillary block and recurrent IOL subluxation following Yamane technique.
- Factors such as optic-haptic junction stress, iris instability, and scleral tunnel issues may contribute to complications.
- Emphasizes the importance of meticulous surgical technique, appropriate case selection, and diligent patient monitoring.
