Beyond the Conventional: A Modified Yamane Technique
This trimmed haptic solution without glued scleral fixation may be beneficial for patients with bilateral aphakia, microcornea, nystagmus, and vitreous opacity.
Supanji Supanji, MD, MSc, PhD; Dewi Fathin Romdhoniyyah, MD, PhD; Aurelia Priscilla Regita Putri, MD; Hifdza Faza Felisha, MD; Vera Nurohmah Indrawati, S.Si; Ummi Noor Hasanah, S.Kep., Ns; Handayani, S.Kep., Ns; Nurul Imawati, MD; Darmawan M. Sophian, MD; Imam Tiharyo, MD, MSc; Mohammad Nafis Sabirin Mara, MD; Firman Setya Wardhana, MD, MSc; and Muhammad Bayu Sasongko, MD, MEPID, PhD
Retina Today 
Corneal size has a significant influence on planning in refractive surgery, particularly in cases of microcornea. Microcornea is associated with congenital cataracts, predisposing patients to a greater risk of cataractous change in early adulthood.1 This condition can appear alone or with microphthalmos. Microphthalmos can be associated with systemic abnormalities and is frequently accompanied by congenital cataract and nystagmus.2 Such anatomic abnormalities present unique surgical challenges that affect incision size, technique for cataract extraction, IOL selection, power calculation, and implantation1,3; consequently, a specialized technique is often required. Furthermore, aphakic spectacles can induce significant optical aberration, which is often more pronounced with nystagmus. Here, we report a case of a patient with bilateral aphakia, microcornea, nystagmus, and vitreous opacity who underwent pars plana vitrectomy (PPV) and secondary IOL implantation in each eye using a modified Yamane technique featuring custom haptic trimming without glued scleral fixation, resulting in improved visual outcomes. CASE REPORT A 28-year-old woman with bilateral aphakia, microcornea, nystagmus, and vitreous opacity presented to our hospital seeking refractive correction. She had a history of bilateral cataract surgery performed in childhood, which resulted in aphakia in each eye. A comprehensive preoperative evaluation was performed, including visual acuity assessment, refraction, tonometry, slit-lamp biomicroscopy, and OCT of the anterior segment and macula. Her preoperative uncorrected VA (UCVA) was 20/600 OU, improving to 20/200 OU with pinhole. Axial length measurements were 21.86 mm OD and 20.66 mm OS.
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