Functional and anatomical outcomes of Yamane technique-based scleral fixation after complicated cataract surgery versus IOL extraction

Abstract Purpose To evaluate and compare the anatomical and functional outcomes of Yamane scleral-fixated intraocular lens (IOL) implantation in aphakic eyes following complicated cataract surgery (CCS) or prior IOL extraction (IE), using standardized outcome measures. Methods This retrospective study included 50 eyes of 50 patients who underwent Yamane scleral-fixated IOL implantation (CCS: n = 13; IE: n = 37). Best-corrected visual acuity (BCVA), intraocular pressure (IOP), refractive outcomes, endothelial cell density (ECD), and central macular thickness (CMT) were evaluated preoperatively and at 6 months postoperatively. Standardized changes (ΔlogMAR, ΔECD%, ΔCMT%) were calculated. Results BCVA and spherical equivalent improved significantly in both groups ( p < 0.001), with no significant difference in visual gain between groups ( p = 0.063). Absolute astigmatism decreased significantly in the IE group ( p = 0.036) but not in the CCS group ( p = 0.124). IOL-related astigmatism remained low and comparable between groups ( p = 0.765). IOP decreased significantly in the CCS group ( p = 0.036) but remained stable in the IE group ( p = 0.476). ECD decreased significantly in both groups, with no between-group difference in percentage loss ( p = 0.382). CMT remained stable, with no significant differences ( p = 0.974). Complication rates were low, with no severe adverse events. Conclusion Yamane scleral fixation provides safe and effective short-term anatomical and functional outcomes in aphakic eyes following both CCS and IE. Despite differences in surgical history, outcomes were largely comparable between groups across most parameters. Intraocular pressure decreased in eyes undergoing CCS and remained stable in previously operated eyes, reflecting expected physiological responses. These findings further support the Yamane technique as a reliable and versatile option for secondary IOL implantation, with outcomes largely independent of prior lens status. Clinical trial number This study is a retrospective study conducted using data obtained from patient records. It does not involve an interventional clinical trial; therefore, a clinical trial registration number is not applicable.