Comparison of Surgical Outcomes Between Two Modified Yamane Techniques of Scleral Fixation of Intraocular Lenses

Purpose: To compare the surgical outcomes of two modified Yamane techniques for sutureless scleral fixation of intraocular lenses (IOL): trocar-cannula-based fixation and 26-gauge needle-based fixation.Methods: A retrospective analysis was conducted on patients who underwent modified Yamane scleral IOL fixation between January 2023 and June 2024 with a minimum follow-up of 6 months. The outcomes assessed included best corrected visual acuity (BCVA), spherical equivalent, astigmatism, astigmatism, and postoperative complications. Measurements were taken preoperatively and at 1 day, 1 week, 1 month, and 6 months after surgery.Results: Among 86 eyes included, 44 received trocar-cannula-based fixation (trocar group) and 42 received 26-gauge needle-based fixation (needle group). Both groups showed significant improvements in BCVA and spherical equivalent at 6 months postoperatively (BCVA: <i>p</i> = 0.013, <i>p</i> = 0.001; spherical equivalent: <i>p</i> < 0.001, <i>p</i> = 0.014), with no statistically significant differences between the groups (BCVA: <i>p</i> = 0.139; spherical equivalent: <i>p</i> = 0.595). The trocar group demonstrated significantly greater improvement in astigmatism at both 1 month and 6 months (<i>p</i> = 0.046, <i>p</i> = 0.048), as well as in IOL astigmatism at 6 months (<i>p</i> = 0.049). Complication rates did not significantly differ between the groups.Conclusions: Both modified Yamane techniques effectively improved BCVA and spherical equivalent. However, the trocar-cannula-based method yielded superior outcomes in astigmatism correction, suggesting a potential advantage in postoperative refractive stability.