Yamane Technique Versus Prolene Mesh for Intraocular Lens Scleral Fixation in Aphakia

Area of Science:

• Ophthalmology
• Surgical Techniques
• Intraocular Lenses

Background:

• Aphakia, or the absence of an eye's natural lens, presents challenges in visual rehabilitation, especially when capsular support is compromised.
• Restoring visual function in aphakic patients without capsular support requires specialized intraocular lens (IOL) fixation methods.
• Complicated cataract surgeries or trauma can lead to partial or total loss of capsular support, necessitating alternative IOL implantation strategies.

Purpose of the Study:

• To compare the efficacy and safety of the transscleral prolene mesh technique versus the Yamane technique for IOL fixation in aphakic eyes.
• To evaluate postoperative visual acuity, refractive outcomes, IOL centration, and complication rates between the two surgical methods.
• To determine the preferred technique for managing aphakia in patients with absent capsular support.

Main Methods:

• A prospective, randomized comparative study involving 40 aphakic eyes (40 patients) lacking capsular support.
• Patients were randomized into two groups: Group A (Yamane technique) and Group B (transscleral prolene mesh technique).
• Follow-up included assessment of uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), intraocular pressure (IOP), refractive errors, and IOL tilt over 3 months.

Main Results:

• No statistically significant differences were observed between the groups in terms of age, gender, UCVA, BCVA, IOP, or refractive errors (p ≥ 0.05).
• Group A (Yamane) experienced a higher complication rate (7/20) including IOL tilt, decentration, and pseudophakic reverse pupillary block.
• Group B (transscleral prolene mesh) had fewer complications (4/20), primarily IOL tilt and decentration.

Conclusions:

• The transscleral prolene mesh technique demonstrated a considerable improvement in visual outcomes compared to the Yamane technique.
• The prolene mesh technique may represent a safer surgical option with a lower incidence of predictable complications.
• Both techniques showed no significant differences in refractive outcomes, but prolene mesh offered better IOL stability.