A dislocated intraocular lens (IOL) is a rare yet serious complication that occurs when the intraocular lens moves out of its normal position in the eye. It can happen after cataract surgery, vitreoretinal surgery and eye trauma. The most common symptom of a dislocated IOL is a change in vision. How much of the vision is affected depends on the severity of the dislocation.
It’s important to address a dislocated IOL right away as it can lead to other complications such as retinal detachment, intraocular inflammation, macular edema or glaucoma. Fortunately, there are several different approaches to treating this complication, one of them being the sutureless Yamane technique.
What is the Yamane Technique?
Multiple IOL fixation techniques have been used over the years to treat a detached IOL. However, some eye doctors are transitioning from suture techniques to sutureless haptic fixation techniques like the Yamane technique.
The idea behind the Yamane technique is to externalize the haptics of a three-piece IOL using thin needles. The haptics of the IOL are carefully laced into the lumen of the needles using intraocular forceps. The needles are then used to externalize the haptics on the conjunctival surface.
The next step is for low-temperature cautery to make a flange at the end of the haptics. The flange prevents the haptics from slipping back into the posterior chamber. Finally, the three-piece IOL is fixated in the posterior segment in the absence of capsular support. You can read more about the specific steps to this technique here.
Key Principles for Successful IOL Implants
The Yamane technique requires practice, as some of the steps are likely to be foreign to some eye surgeons. For example, threading the haptics into the needle lumen can be challenging on the first few attempts.
Here are the four key principles for a successful Yamane technique:
- IOL choice. The material construction of the haptics dictate which type of cautery is successful and which will hold the desired shape.
- Needles. Because of the outer diameter of the haptics, the inner lumen of the needle must be large enough. This is why the 30-gauge needle is most commonly used.
- Intraocular forceps. Threading the haptics into the needle lumen is difficult to do. To help, the eye surgeon will generally use intraocular forceps that are constructed of a small, needle-shaped tip. This provides sufficient grip during the procedure.
- Anterior chamber maintainer. An anterior or posterior chamber infusion is necessary for maintaining adequate working space inside the eye.
The Yamane technique has become the preferred method for IOL fixation when there is not enough capsular support for a traditional IOL. It’s safe and effective, though it does require a surgeon’s expertise. Empire Retina Consultants is comfortable using the Yamane technique for successful surgeries. Contact us today to learn more about our approach to fixing a dislocated IOL.