Intrascleral (Yamane Technique) Versus Trans-scleral (ab externo Technique) Intraocular Lens Implantation in Pediatric Aphakia: Prospective Randomized Study

Abstract Purpose to compare between intrascleral (Yamane Technique) and trans-scleral (ab externo technique) posterior chamber intraocular lens (PCIOL)implantation in cases of pediatric aphakia. Patients and methods: a prospective interventional study included 20 aphakic eyes < 18 years old with insufficient capsular support. Patients were randomly assigned into two groups; group (1) underwent sutureless intrascleral IOL implantation using Yamane technique and group (2) underwent trans-scleral IOL implantation (ab externo technique). Outcome measures included visual acuity (uncorrected UCVA& best corrected BCVA), astigmatism (corneal and IOL-induced), Keratometric readings, IOL state and any developed surgical complications. Patients were followed for at least 6 months. Results There was a statistically significant improvement in UCVA and BCVA at 6th month compared to preoperative values, without significant difference between the 2 groups. Corneal astigmatism was higher in group (2) whereas IOL-induced astigmatism was higher in group (1) with no statistically significant difference between the 2 groups in both parameters. IOL tilt was higher in group (1), but the difference was not significant. There was a statistically significant higher adjusted post-operative K2-reading in group (2) with no difference in adjusted post-operative K1-reading between the two groups. There was no statistical difference between the 2 groups regarding postoperative complications. Conclusion Both techniques for scleral fixation PCIOL resulted in comparable visual outcomes in pediatric cases with aphakia. Sutureless intrascleral fixed IOL results in lower corneal astigmatism with good IOL stability and centration.