Macular and functional outcomes after secondary IOL implantation using the Yamane technique in aphakia, IOL subluxation, and IOL dislocation

Purpose: To assess whether preoperative lens status—aphakia, intraocular lens (IOL) subluxation, or complete IOL dislocation—influences retinal and functional outcomes after secondary IOL implantation using the Yamane technique. Methods: This retrospective study included 59 eyes undergoing the Yamane technique: 13 aphakic, 25 with subluxated IOLs, and 21 with dislocated IOLs. All patients completed a 12-month follow-up with spectral-domain OCT at 1, 3, and 12 months. The primary endpoint was cystoid macular edema (CME) or epiretinal membrane (ERM). Secondary endpoints were best-corrected visual acuity (BCVA), subjective refractive astigmatism (SRAST), and endothelial cell density (ECD). A quantile regression model was used to identify predictors of visual improvement. Results: At 3 months, CME was observed in 19 eyes (32.2%). After excluding eyes with pre-existing macular changes, incident postoperative CME occurred in 6 eyes (10.2%). At 12 months, CME was present in 8 eyes (13.6%). Postoperative ERM developed in 5 eyes (8.5%). BCVA improved significantly in all three groups (p < 0.001), and SRAST remained stable (p = 0.819). ECD decreased significantly in subluxated and dislocated eyes but not in aphakic eyes. Baseline BCVA was the only independent predictor of visual improvement at 12 months. Conclusion: Retinal and functional outcomes after Yamane fixation were comparable across aphakia, IOL subluxation, and IOL dislocation. Although a transient peak in CME prevalence was observed at 3 months, the incidence of new postoperative CME was limited and mainly associated with IOL explantation. Visual recovery was primarily determined by preoperative visual acuity.