The Refractive Outcomes of Sutured and Sutureless Scleral Fixation (the Yamane Technique)

Abstract

Purpose: To evaluate the pre- and post-operative refractive powers of patients undergoing sutured and sutureless scleral fixation (the latter: the Yamane technique).Methods: Patients who had undergone sutured or sutureless scleral fixation to treat intraocular lens (IOL) dislocation or phacodonesis at Dong-A University Hospital from January 2017 to December 2021 were retrospectively investigated. The preoperatively predicted spherical equivalents (derived using the radii of corneal curvature) were measured via optical coherence topography and the axial lengths were determined using an IOL master ® (Zeiss, Carl Zeiss Meditec, Jena, Germany) device and A-scan biometry (AL-100; Tomey, Nagoya, Japan) ultrasound. The spherical equivalent was measured 1 month after surgery employing an automatic refractive keratometer. The extent of agreement between the predicted and actual spherical equivalents were compared between the sutured and sutureless scleral fixation groups.Results: The sutured scleral fixation group included 20 eyes and the sutureless group 12 eyes. The preoperatively predicted spherical equivalent of the sutured group was -0.158 ± 0.577 diopters (D) on A-scan (Tomey) ultrasound and -0.143 ± 0.617 D employing the IOL master ® (Carl Zeiss Meditec); both correlated poorly with the postoperatively measured spherical equivalent of -0.400 ± 0.923 D (p = 0.903, 0.563). However, the predicted spherical equivalent of the group undergoing sutureless fixation was -0.340 ± 0.368 D on A-scan ultrasound and -0.183 ± 0.251 D using the IOL master ® (Carl Zeiss Meditec); both correlated significantly with the postoperatively measured spherical equivalent of -0.313 ± 1.129 D (p = 0.038, 0.005).Conclusions: The preoperatively predicted refractive power correlated significantly with the postoperative refractive power after sutureless but not sutured scleral fixation. Sutureless fixation was safe and the postoperative refractive power was comparable to that of sutured fixation.