Safety and efficacy of the Yamane technique for intraocular three-piece lens implantation in Egyptian patients diagnosed with Marfan syndrome: a retrospective study

Abstract Background This study aimed to investigate the safety and efficacy of the Yamane technique (flanged intrascleral haptic fixation with double-needle technique /FIHFT) for three-piece intraocular lens (IOL) implantation in Egyptian patients diagnosed with Marfan syndrome (MFS) presented with...

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Main Authors: Fathy Mohamed Abo Elftouh Elsalhy, Ahmed Hassan Samir Assaf, Sarah Abbas Alshamarti, Noha Fawky Soliman, Abdelrahman Ahmed Ali Khattab, Mahmoud Mohammed Ahmed Ali Khalil, Mahmoud Fawzy Zaky Morsy, Ezzat Nabil Abbas Ibrahim, Ahmad Mohammad Salah Eldeen Abdul Hay, Mohamed Sayed Taha Abouzeid
Format: Article
Language:English
Published: BMC 2024-11-01
Series:BMC Ophthalmology
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Online Access:https://doi.org/10.1186/s12886-024-03724-y
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author Fathy Mohamed Abo Elftouh Elsalhy
Ahmed Hassan Samir Assaf
Sarah Abbas Alshamarti
Noha Fawky Soliman
Abdelrahman Ahmed Ali Khattab
Mahmoud Mohammed Ahmed Ali Khalil
Mahmoud Fawzy Zaky Morsy
Ezzat Nabil Abbas Ibrahim
Ahmad Mohammad Salah Eldeen Abdul Hay
Mohamed Sayed Taha Abouzeid
author_facet Fathy Mohamed Abo Elftouh Elsalhy
Ahmed Hassan Samir Assaf
Sarah Abbas Alshamarti
Noha Fawky Soliman
Abdelrahman Ahmed Ali Khattab
Mahmoud Mohammed Ahmed Ali Khalil
Mahmoud Fawzy Zaky Morsy
Ezzat Nabil Abbas Ibrahim
Ahmad Mohammad Salah Eldeen Abdul Hay
Mohamed Sayed Taha Abouzeid
author_sort Fathy Mohamed Abo Elftouh Elsalhy
collection DOAJ
description Abstract Background This study aimed to investigate the safety and efficacy of the Yamane technique (flanged intrascleral haptic fixation with double-needle technique /FIHFT) for three-piece intraocular lens (IOL) implantation in Egyptian patients diagnosed with Marfan syndrome (MFS) presented with subluxated lenses (ectopia lentis, EL). Methods This was a retrospective evaluation of thirty-three patients who were diagnosed with MFS and had subluxated lenses in a total of forty eyes. Seven of these patients had bilateral subluxation. Lensectomy or phacoemulsification was performed with limited anterior vitrectomy, followed by IOL implantation using the FIHFT method. Data was collected from medical records, including preoperative and postoperative corrected distant visual acuity (CDVA) using logarithm of the minimal angle of resolution (log MAR), preoperative and postoperative refractions, intraoperative and postoperative complications, and follow-up periods. Results The mean age of patients in the study was 30.79 years, with a mean follow-up of 23.9 months. Post-surgery, the refractive sphere decreased significantly from -9.1 ± 1.4 diopter (D) to -1.4 ± 0.7 D, and cylinder measurements dropped from -4.5 ± 0.8 D to -1.4 ± 0.6 D. The spherical equivalent (SEQ) also declined from -11.4 ± 1.5 D to -2.1 ± 0.8 D. The CDVA improved from 0.80 ± 0.32 to 0.18 ± 0.10 log MAR (P < 0.001). No intraoperative complications were identified. Postoperative complications included IOL decentration (12.5%), vitreous hemorrhage (7.5%), IOL slippage (5%), IOL tilt (5%), and retinal detachment (RD) (5%). Further surgical procedures were necessary for only four cases (10%), all of which had positive outcomes. IOL tilting and slippage occurring at average ages of 18 and 19 years, respectively. No other complications, such as hypotony, elevated intraocular pressure (IOP), corneal edema, iritis, IOL dislocation, cystoid macular edema (CME) or endophthalmitis, were reported. Conclusions The Yamane technique has proven effective and safe for treating subluxated lenses in Egyptian patients with Marfan Syndrome, resulting in improved visual acuity with minimal complications, mostly minor and manageable. Comprehensive fundus examinations before and after surgery are essential for promptly identifying retinal breaks and reducing the risk of retinal detachment. IOL tilting and slippage are more common in younger patients.
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spelling doaj-art-069372ca45f14ee5908ce621a2a2a8412025-08-20T02:13:27ZengBMCBMC Ophthalmology1471-24152024-11-0124111010.1186/s12886-024-03724-ySafety and efficacy of the Yamane technique for intraocular three-piece lens implantation in Egyptian patients diagnosed with Marfan syndrome: a retrospective studyFathy Mohamed Abo Elftouh Elsalhy0Ahmed Hassan Samir Assaf1Sarah Abbas Alshamarti2Noha Fawky Soliman3Abdelrahman Ahmed Ali Khattab4Mahmoud Mohammed Ahmed Ali Khalil5Mahmoud Fawzy Zaky Morsy6Ezzat Nabil Abbas Ibrahim7Ahmad Mohammad Salah Eldeen Abdul Hay8Mohamed Sayed Taha Abouzeid9Department of Ophthalmology, Faculty of Medicine, Al-Azhar UniversityDepartment of Ophthalmology, Faculty of Medicine, Ain Shams UniversityDepartment of Ophthalmology, Faculty of Medicine, Al-Qadisiyah UniversityFRCS Edinburgh (Ophthalmology), FICO, Watany Eye HospitalsDepartment of Ophthalmology, Faculty of Medicine, Al-Azhar UniversityDepartment of Ophthalmology, Faculty of Medicine, Al-Azhar UniversityDepartment of Ophthalmology, Faculty of Medicine, Al-Azhar UniversityDepartment of Ophthalmology, Faculty of Medicine, Al-Azhar UniversityDepartment of Ophthalmology, Faculty of Medicine, Al-Azhar UniversityDepartment of Ophthalmology, Faculty of Medicine, Beni Suef UniversityAbstract Background This study aimed to investigate the safety and efficacy of the Yamane technique (flanged intrascleral haptic fixation with double-needle technique /FIHFT) for three-piece intraocular lens (IOL) implantation in Egyptian patients diagnosed with Marfan syndrome (MFS) presented with subluxated lenses (ectopia lentis, EL). Methods This was a retrospective evaluation of thirty-three patients who were diagnosed with MFS and had subluxated lenses in a total of forty eyes. Seven of these patients had bilateral subluxation. Lensectomy or phacoemulsification was performed with limited anterior vitrectomy, followed by IOL implantation using the FIHFT method. Data was collected from medical records, including preoperative and postoperative corrected distant visual acuity (CDVA) using logarithm of the minimal angle of resolution (log MAR), preoperative and postoperative refractions, intraoperative and postoperative complications, and follow-up periods. Results The mean age of patients in the study was 30.79 years, with a mean follow-up of 23.9 months. Post-surgery, the refractive sphere decreased significantly from -9.1 ± 1.4 diopter (D) to -1.4 ± 0.7 D, and cylinder measurements dropped from -4.5 ± 0.8 D to -1.4 ± 0.6 D. The spherical equivalent (SEQ) also declined from -11.4 ± 1.5 D to -2.1 ± 0.8 D. The CDVA improved from 0.80 ± 0.32 to 0.18 ± 0.10 log MAR (P < 0.001). No intraoperative complications were identified. Postoperative complications included IOL decentration (12.5%), vitreous hemorrhage (7.5%), IOL slippage (5%), IOL tilt (5%), and retinal detachment (RD) (5%). Further surgical procedures were necessary for only four cases (10%), all of which had positive outcomes. IOL tilting and slippage occurring at average ages of 18 and 19 years, respectively. No other complications, such as hypotony, elevated intraocular pressure (IOP), corneal edema, iritis, IOL dislocation, cystoid macular edema (CME) or endophthalmitis, were reported. Conclusions The Yamane technique has proven effective and safe for treating subluxated lenses in Egyptian patients with Marfan Syndrome, resulting in improved visual acuity with minimal complications, mostly minor and manageable. Comprehensive fundus examinations before and after surgery are essential for promptly identifying retinal breaks and reducing the risk of retinal detachment. IOL tilting and slippage are more common in younger patients.https://doi.org/10.1186/s12886-024-03724-yMarfan syndromeEctopia lentisLenticular astigmatismScleral lens fixationYamane technique
spellingShingle Fathy Mohamed Abo Elftouh Elsalhy
Ahmed Hassan Samir Assaf
Sarah Abbas Alshamarti
Noha Fawky Soliman
Abdelrahman Ahmed Ali Khattab
Mahmoud Mohammed Ahmed Ali Khalil
Mahmoud Fawzy Zaky Morsy
Ezzat Nabil Abbas Ibrahim
Ahmad Mohammad Salah Eldeen Abdul Hay
Mohamed Sayed Taha Abouzeid
Safety and efficacy of the Yamane technique for intraocular three-piece lens implantation in Egyptian patients diagnosed with Marfan syndrome: a retrospective study
BMC Ophthalmology
Marfan syndrome
Ectopia lentis
Lenticular astigmatism
Scleral lens fixation
Yamane technique
title Safety and efficacy of the Yamane technique for intraocular three-piece lens implantation in Egyptian patients diagnosed with Marfan syndrome: a retrospective study
title_full Safety and efficacy of the Yamane technique for intraocular three-piece lens implantation in Egyptian patients diagnosed with Marfan syndrome: a retrospective study
title_fullStr Safety and efficacy of the Yamane technique for intraocular three-piece lens implantation in Egyptian patients diagnosed with Marfan syndrome: a retrospective study
title_full_unstemmed Safety and efficacy of the Yamane technique for intraocular three-piece lens implantation in Egyptian patients diagnosed with Marfan syndrome: a retrospective study
title_short Safety and efficacy of the Yamane technique for intraocular three-piece lens implantation in Egyptian patients diagnosed with Marfan syndrome: a retrospective study
title_sort safety and efficacy of the yamane technique for intraocular three piece lens implantation in egyptian patients diagnosed with marfan syndrome a retrospective study
topic Marfan syndrome
Ectopia lentis
Lenticular astigmatism
Scleral lens fixation
Yamane technique
url https://doi.org/10.1186/s12886-024-03724-y
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