Standardizing the Yamane flanged intrascleral haptic fixation: A framework for efficacy, complication mitigation, and reproducible training

Table 1 Clinical indications for the Yamane scleral-fixated intraocular lens technique

Category	Clinical indication	Surgical context	Typical etiology
Aphakia	Aphakia after complicated cataract surgery	Insufficient capsular support prevents standard in-the-bag implantation; Yamane fixation allows stable posterior chamber IOL placement without sutures	Posterior capsule rupture, zonular dialysis
IOL-capsular bag complex instability	Late dislocation of in-the-bag IOL-capsular bag complex	Progressive zonular weakness leads to displacement of the entire complex; fixation independent of residual capsule is required	Pseudoexfoliation syndrome, zonulopathy, high myopia, aging
Trauma	Traumatic lens loss or unstable capsular remnants	Loss of crystalline lens or unstable capsule makes conventional fixation unreliable; Yamane technique permits controlled posterior chamber positioning	Ocular trauma
Secondary aphakia	Aphakia after IOL explantation	Removal of opacified or malpositioned IOL may leave insufficient capsular support; Yamane fixation enables secure secondary implantation	IOL opacification, malposition, prior surgical complications
Post surgical	Vitreoretinal surgery/PPV complications	Capsular instability after pars plana vitrectomy	Compromised capsular integrity

IOL: Intraocular lens; PPV: Pars plana vitrectomy.