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.