The Yamane technique for IOL fixation to the sclera is an innovative way to secure a three-piece IOL in the posterior chamber. It can be performed with a variety of IOL designs and the idea is to externalize the haptics through small scleral tunnels created at an angle using a special thin-walled 30g needle. The tips of the haptics are then melted with cautery to create flanges that prevent the haptic from going back inside the eye. This bulbous tip can then be securely lodged within the sclera for further protection. The key in this surgery is to avoid entangling the haptics and the optic with the vitreous. If you are an anterior segment surgeon, you may find better results by working with a vitreo-retinal colleague to perform a complete pars plana vitrectomy prior to doing the Yamane technique.
click to learn from this case of IOL exchange with Yamane scleral fixation of the new IOL: