Haptic-Optic Fractures in Yamane Flanged Intrascleral Fixated Lenses: A Case Series

Purpose: To report five cases of structural weakness at the haptic-optic junction of the CT Lucia 602 intraocular lens (IOL) (Carl Zeiss Meditec Inc., Dublin, CA), including two optic breakages and three optic microfractures, while using the Yamane flanged intrascleral haptic fixation surgery (FIHFS). Methods: A retrospective chart review of five cases that underwent Yamane FIHFS by the same surgeon between 2020 and 2022 was performed. Patients’ demographics, operative technique, postoperative outcomes, and adverse events were recorded over a 12-month followup period. Results: One case of optic breakage, noted on postoperative week 1 (POW1), had the optic with the trailing haptic suspended in the vitreous while both haptic flanges remained secured to the sclera, requiring IOL exchange. The second case of optic breakage was noted intraoperatively and required explantation of the IOL with subsequent placement of an iris-fixated IOL. Three cases of optic microfractures were observed with no long-term complications. All five fractures occurred at the junction of the leading haptic. Conclusion: Optic breakage and microfractures at the haptic-optic junction are unusual complications of intrascleral fixated IOL using the Yamane technique. To the best of our knowledge, this has not been previously reported with the CT Lucia 602 IOL. The authors recommend careful selection of the IOL material for this technique to prevent possible complications.