Modified suture-less flanged intrascleral intraocular lens fixation approach accessible for novice retinal surgeons.

PURPOSE: To evaluate whether two simplified mo-difications of flanged intrascleral fixation techniques (Yamane and Canabrava) provide comparable refractive outcomes and complication rates while reducing surgical complexity in tro-car-assisted vitrectomy.

METHODS

This retrospective observational study included 88 patients who underwent flanged fixation surgery with vitrectomy. In the modified Yamane technique, a single-path sclerotomy with bilateral symmetry was performed instead of an angled sclerotomy. In the modified Canabrava technique, the intraocular lens was inserted first, followed by the creation of a circular polypropylene loop with 2-mm flange spacing. Postoperative refractive parameters, including intraocular lens astigmatism, and complications such as intraocular lens iris capture were analyzed.

RESULTS

Of the 88 patients, 70 underwent the modified Yamane technique, and 18 underwent the modified Canabrava technique. No significant differences were observed between the two techniques regarding refractive outcomes or postoperative complications, except for surgical duration, which was significantly shorter (p<0.001) in one technique. Mean intraocular lens astigmatism was -0.675 D for Yamane and -0.666 D for Canabrava.

CONCLUSION

Optimizing needle engagement for symmetry in the Yamane technique and narrowing flange spacing while ensuring a circular polypropylene configuration in the Canabrava technique may reduce surgical complexity and improve postoperative outcomes.