MANAGEMENT OF TRAUMATIC APHAKIA IN SEVERE OCULAR TRAUMA: A COMPARATIVE ANALYSIS OF SCLERAL-SUTURED INTRAOCULAR LENSES VERSUS THE YAMANE TECHNIQUE

This study aims to assess the clinical effectiveness of scleral-sutured intraocular lenses (IOLs) versus the Yamane technique in the management of traumatic aphakia following severe ocular trauma.

Ocular Trauma Unit, Hospital del Salvador, a national referral center.

A retrospective review was conducted on 142 patients who presented with traumatic aphakia resulting from severe ocular trauma between 2021 and 2023. Patients were assigned to one of two surgical technique groups: the Yamane technique (n = 87, mean age = 55.66 years) or scleral-sutured Micropure IOL (n = 55, mean age = 53.35 years). Gender distribution included 72 males and 15 females in the Yamane group, and 45 males and 10 females in the Micropure group (p = 0.82, Student’s t-test). Trauma mechanisms were categorized as contusive (64 in the Yamane group and 35 in the Micropure group) and penetrating (23 in the Yamane group and 20 in the Micropure group), with no significant difference (p = 0.30, chi-squared test). Initial visual acuity (VA) was recorded as 1.84 LogMAR for the Yamane group and 1.95 LogMAR for the Micropure group (p = 0.47).

Preoperative VA averaged 1.38 LogMAR in the Yamane group and 1.22 LogMAR in the Micropure group (p = 0.08). On the first postoperative day, the Yamane group demonstrated a statistically significant improvement in VA (0.91 LogMAR) compared to the Micropure group (1.31 LogMAR, p = 0.002). At one week, VA was 0.58 LogMAR in the Yamane group versus 0.81 LogMAR in the Micropure group (p = 0.03). At one month, the Yamane group achieved an average VA of 0.45 LogMAR compared to 0.54 LogMAR in the Micropure group (p = 0.28). By three months, the VA outcomes were comparable, at 0.43 for the Yamane group and 0.47 for the Micropure group (p = 0.78). These findings align with current literature, highlighting faster visual rehabilitation with the Yamane technique. No significant differences in macular edema incidence were observed between groups (Risk ratio: 1.01, p = 0.98), nor in overall complication rates (Risk ratio: 1.06, p = 0.79).

This study indicates that the Yamane technique enables a faster recovery in early postoperative visual acuity compared to scleral-sutured IOLs, while long-term outcomes remain comparable between techniques. Both methods appear effective for managing traumatic aphakia, though the Yamane approach may offer an advantage in terms of early rehabilitation.