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

Background: Sutureless intrascleral intraocular lens (IOL) fixation using the Yamane technique is an option for visual rehabilitation in eyes without capsular support. The aim of this study is to report long-term visual outcomes and clinical predictors in consecutive real-world cohorts, a topic addressed by very few previous studies. Methods: This was a single-center, single-surgeon consecutive case series including 87 eyes of 85 patients who underwent Yamane SFIOL for aphakia or lens/posterior chamber IOL ectopia, with at least 12 months of follow-up. BCVA was measured using a Snellen chart and recorded in decimal notation. To identify predictors of postoperative BCVA, univariable screening was first performed, followed by a clinically driven multivariable linear mixed-effect regression. Results: Mean age was 68.2 ± 11.4 years, and 70.6% were male. Median follow-up was 26.5 months. Median BCVA improved from 0.2 ± 0.2 (range 0.001–1.0) preoperatively to 0.9 ± 0.2 (range 0.2–1.0) postoperatively (p < 0.001). Surgical indication and preoperative comorbidity burden were not linked to postoperative BCVA. In the 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) independently predicted lower postoperative BCVA. Conclusions: Yamane SFIOL provides significant long-term visual improvement, with outcomes mainly determined by patient age and retinal status. This study offers new data on functional outcomes and clinically relevant predictors in a consecutive real-world cohort, supporting the reliability and long-term efficacy of sutureless scleral IOL fixation.