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Yamane Anterior Segment Approach Basic

Basic description of the Yamane double needle flanged haptic scleral fixation technique. The haptics of a 3 piece intraocular lens are loaded into two needles (typically 30 gauge, thin walled) and these are externalized outside of the eye via oblique scleral tunnels about 2mm long. The haptic ends are then melted into a small "flange" or bulb that serves to hold the haptic in the sclera. This way the lens is fixated to the sclera without sutures. Additionally, this technique avoids the need for a conjunctival cut down (peritomy) which reduces time and scarring. From an anterior segment approach, I use an anterior chamber maintainer which keeps the eye firm throughout the procedure and it also keeps the iris away from the wounds by directing the fluid posteriorly instead of anteriorly.