A Novel Modification of the Yamane Intrascleral Haptic Fixation Technique with Scleral Groove-Flap Coverage: A Case Series Study.

PURPOSE: To describe a modification of the Yamane double-needle technique using partial-thickness scleral groove-flap coverage of the terminal haptic flanges for secondary IOL implantation in eyes without adequate capsular support. METHODS: This surgical technique report describes a modified approach to flanged intrascleral haptic fixation (ISHF). At two fixation sites 180° apart, partial-thickness scleral grooves are created. After haptic externalization and cauterization, the terminal flanges are guided into the grooves and buried beneath scleral tissue rather than positioned directly beneath the conjunctiva. RESULTS: The technique was successfully performed in three eyes requiring secondary IOL implantation without adequate capsular support. At 12 months postoperatively, all patients demonstrated stable IOL centration with complete conjunctival epithelialization over the haptic sites. No cases of haptic exposure, endophthalmitis, or flange-related irritation were observed. CONCLUSION: The scleral groove-flap modification preserves the essential workflow of the Yamane technique while providing additional scleral tissue coverage over the terminal haptic flanges. In this small case series without a comparison group, the technique was associated with stable IOL centration, complete conjunctival epithelialization, and no observed haptic exposure during 12 months of follow-up.