Comparative Outcomes of Transscleral Four-Point Fixation with Closed Continuous-Loop Suture and Yamane Technique for Intraocular Lens Fixation.

Authors

Jin Cho, Yong Joon Kim, Junwon Lee, Christopher Seungkyu Lee, Min Kim, Suk Ho Byeon, Sung Soo Kim, Jay Jiyong Kwak

Published in

Retina (Philadelphia, Pa.). Aug 20, 2026. Epub Aug 20, 2026.

Abstract

To compare the outcomes of transscleral four-point fixation using a closed continuous-loop suture and transconjunctival intrascleral haptic fixation (Yamane technique) for intraocular lens (IOL) fixation.
Patients who underwent scleral fixation of IOL using four-point fixation with a closed continuous-loop suture and the Yamane technique were reviewed. Demographics, pre- and postoperative data, including operation time, complications, and reoperation rates, were reviewed. The cumulative probability of remaining free from IOL redislocation was analyzed using Kaplan-Meier curves, and the factors associated with IOL redislocation were assessed using a Cox proportional hazards model.
A total of 179 eyes of 175 patients were included, comprising 120 eyes in the four-point fixation group and 59 eyes in the Yamane group. Visual and refractive outcomes were comparable 6 months postoperatively. Operative time was significantly shorter in the Yamane group (35.6 ± 10.9 vs. 49.5 ± 14.7 min; p < 0.001). Postoperative complication rates, including corneal decompensation, hypotony, and endophthalmitis, did not differ significantly between groups. Cox proportional hazards model showed that the Yamane technique was associated with a significantly higher hazard of IOL redislocation (hazard ratio, 8.68; 95% confidence interval, 1.38-54.46; p = 0.021).
Both four-point fixation and the Yamane technique yielded comparable visual outcomes and safety profiles. The Yamane technique offered shorter operative time, whereas the four-point fixation was associated with a lower risk of IOL redislocation. These findings highlight the importance of preoperative structural assessments in guiding the selection of fixation methods.

PMID:
42622535
Bibliographic data and abstract were imported from PubMed on 20 Aug 2026.

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