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

Table 5 Standardized surgical parameters for the Yamane flanged intrascleral haptic fixation technique

Surgical parameter	Recommended value/range	Rationale
Needle gauge	30-gauge	Matches standard haptic diameter; minimizes scleral trauma
Scleral entry distance from limbus	2.0-2.5 mm	Avoids ciliary body; ensures adequate fixation depth
Entry angle	Approximately 20° to limbus/approximately 5° to iris plane	Achieves tunnel length ≥ 2.0 mm for stable haptic retention
Intrascleral tunnel length	≥ 2.0 mm	Reduces risk of haptic slippage and IOL dislocation
Needle separation (symmetry)	180° apart	Ensures IOL centration and minimizes postoperative tilt
Bevel orientation	Bevel-up (preferred); surgeon-dependent	Facilitates haptic capture and reduces deformation risk
Flange diameter	0.3-0.5 mm	Prevents haptic slippage without excessive thermal damage
Cautery application	Low-temperature, brief contact	Avoids haptic brittleness or fracture from excessive heat

IOL: Intraocular lens.