Long-Term Visual Outcome and Clinical Predictors Following Yamane Sutureless Intrascleral IOL Fixation

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Abstract

Sutureless intrascleral intraocular lens fixation using the Yamane technique is an established option for visual rehabilitation in eyes without capsular support. This study evaluated long-term visual outcomes and predictors of postoperative best-corrected visual acuity (BCVA) following Yamane SFIOL implantation. In this single-center, single-surgeon consecutive case series, patients undergoing surgery for aphakia or lens/posterior chamber intraocular lens ectopia with ≥12 months of follow-up were included. BCVA was measured using a standard Snellen chart and recorded in decimal notation. Univariable screening followed by clinically driven multivariable linear mixed-effect regression was performed. Eighty-seven eyes of 85 patients were analyzed (mean age 68.2 ± 11.4 years; 70.6% male). Median BCVA improved significantly from 0.2 preoperatively to 0.9 postoperatively (p < 0.001), with a median follow-up of 26.5 months. Surgical indication was not associated with postoperative BCVA (B = −0.015, p = 0.752), nor was preoperative comorbidity burden. In multivariable analysis, older age (B = −0.005, p = 0.027), macular edema (B = −0.242, p = 0.035), and prior silicone oil removal (B = −0.237, p = 0.046) were independently associated with lower postoperative BCVA. Yamane SFIOL provides significant long-term visual improvement, while postoperative visual outcomes are primarily determined by age and retinal status.

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