Long-Term Assessment of Intraocular Lens Stability, Tilt and Decentration Between Four-Point Scleral Fixation and Yamane Techniques

Background: To compare tilt and decentration results of two scleral fixation intraocular lens (IOL) methods of four-point scleral fixation (Akreos AO60) and the Yamane technique (AcrySof MA60AC). Methods: Two groups were compared in terms of IOL decentration and tilt at day 30 and 2 years after surgery. Correlations between IOL tilt and decentration and previous pars plana vitrectomy (PPV), axial length (AL), refractive error (RE), astigmatism, and spherical equivalent (SE) were also analyzed. Results: This study included 50 eyes from 47 patients: four-point fixation in 25 eyes (group 1) and Yamane technique in 25 eyes (group 2). The mean horizontal tilt was 1.66° ± 1.45° in group 1 and 5.06° ± 4.65° in group 2. The horizontal tilt value was significantly higher (p < 0.05) in group 2. The mean vertical tilt for group 1 and group 2 at two year’s observation was 1.74° ± 2.16° and 3.09° ± 2.79° respectively (p = 0.02). The mean horizontal IOL decentration was 0.35 ± 0.32 mm in group 1 and 0.34 ± 0.26 mm in group 2 (p > 0.05). The mean vertical IOL decentration in group 1 was 0.34 ± 0.33 mm and in group 2 it was 0.27 ± 0.20 mm respectively (p = 0.45). No statistically significant changes in tilt and decentration time were demonstrated in both groups (p > 0.05). There was no statistically significant correlation between IOL tilt and decentration and previous PPV in both groups. Conclusions: Both techniques provide good centration and stability IOL in aphakic eyes in the absence of capsular support.