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

To evaluate transscleral prolene mesh in aphakic patients lacking capsular support by comparing this technique with the Yamane technique.

A comparative, prospective, randomized study was conducted on 40 eyes of 40 patients who were aphakic without capsular support. Aphakia is either posttraumatic or after complicated cataract surgery with partial or total loss of capsular support. Patients were randomly assigned to one of two groups based on the surgical intervention they received: Group A (Yamane technique) and Group B (transscleral prolene mesh technique). All patients were followed up for 3 months after surgery. Postoperative visual acuity, refraction, IOL centration, and complications were documented during the follow-up period.

Patients in both groups were comparable for both ages, 55.78 (± 8.63) for Group A and 59.10 (± 9.95) for Group B, and gender. In Group A, 50% were males and 50% were females. In Group B, 60% were males and 40% were females. After excluding complicated cases, both groups were compared for preoperative and postoperative results (UCVA, BCVA, IOP, refractive errors, and IOL tilt). The two groups had no statistically significant differences (p value ≥ 0.05). Moreover, refractive errors (sphere and cylinder) showed a strong negative correlation to IOL tilt of more than 5° for both groups. Seven patients out of twenty were complicated in Group A. Three patients had IOL tilt > 5°, 2 had IOL decentration > 0.2 mm, and two had pseudophakic reverse pupillary block. Four patients out of twenty had complications in Group B. Two patients had IOL tilt > 5°, and the rest had IOL decentration > 0.2 mm.

The prolene mesh technique showed a considerable improvement in visual outcome compared to the Yamane technique and may even offer a safer option with fewer predictable complications. Trial Registration: ClinicalTrials.gov idendifier: NCT06363448.