Prediction error following Yamane flanged intrascleral haptic fixation in pediatric cataract surgery

To evaluate early postoperative prediction error (PE) following Yamane flanged intrascleral haptic fixation of an intraocular lens (IOL) in pediatric eyes and to describe subsequent refractive shift over time.

The medical records of consecutive pediatric patients who underwent Yamane flanged intrascleral-haptic fixation at a single tertiary eye care center were reviewed retrospectively. The primary outcome was PE at 4 weeks postoperatively, defined as achieved spherical equivalent (SE) minus intended target refraction. Secondary outcomes included refractive shift, defined as the change in SE, from 4 weeks to 6 months, absolute prediction error (APE), refractive accuracy, and best-corrected distance visual acuity (BCDVA).

A total of 20 eyes from 12 consecutive pediatric patients (<15 years) were included. Mean age at surgery was 8.8 ± 2.4 years. At 4 weeks, mean PE was +0.90 ± 1.31 D, indicating an initial hyperopic offset relative to the intended target. From 4 weeks to 6 months, a mean myopic refractive shift of -0.54 D was observed. Median APE improved from 0.96 D at 4 weeks to 0.65 D at 6 months, and the proportion of eyes within ±1.0 D of target increased from 45% to 60%. Mean BCDVA significantly improved from 0.90 ± 0.24 to 0.45 ± 0.23 logMAR (P < 0.001).

In our small study pediatric cohort, Yamane flanged intrascleral haptic fixation yielded significant visual improvement. Early hyperopic PE was common, with partial refractive shift toward the intended target refraction over time.