Macular and Functional Outcomes After Secondary IOL Implantation Using the Yamane Technique in Aphakia, IOL...

Area of Science:

• Ophthalmology
• Retinal Surgery
• Ophthalmic Implants

Background:

• Secondary intraocular lens (IOL) implantation is crucial for visual rehabilitation after cataract surgery complications.
• The Yamane technique offers a reliable method for IOL fixation in complex cases, including aphakia, IOL subluxation, and dislocation.
• Understanding the impact of preoperative lens status on outcomes is essential for patient selection and surgical planning.

Purpose of the Study:

• To evaluate if preoperative lens status (aphakia, subluxated IOL, dislocated IOL) affects retinal and functional outcomes following secondary IOL implantation with the Yamane technique.
• To compare the incidence of cystoid macular edema (CME) and epiretinal membrane (ERM) formation across different preoperative lens statuses.
• To assess changes in best-corrected visual acuity (BCVA), subjective refractive astigmatism (SRAST), and endothelial cell density (ECD) after the procedure.

Main Methods:

• Retrospective analysis of 59 eyes undergoing the Yamane technique for secondary IOL implantation.
• Categorization of eyes into three groups: aphakic, subluxated IOL, and dislocated IOL.
• 12-month follow-up including spectral-domain OCT, BCVA, SRAST, and ECD measurements; analysis using quantile regression.

Main Results:

• Overall CME incidence was 32.2% at 3 months, with new postoperative CME in 10.2% of eyes, primarily after IOL explantation.
• Postoperative ERM developed in 8.5% of eyes.
• Significant BCVA improvement (p < 0.001) was observed in all groups, with stable SRAST (p = 0.819). ECD decreased in subluxated and dislocated IOL groups.
• Baseline BCVA was the sole independent predictor of visual improvement at 12 months.

Conclusions:

• The Yamane technique provides comparable retinal and functional outcomes for secondary IOL implantation in aphakic, subluxated, and dislocated IOL eyes.
• While CME can occur transiently, its incidence is limited and associated with prior IOL issues.
• Preoperative visual acuity is the primary determinant of visual recovery after Yamane fixation.