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Peer-reviewedCC BY 4.0Journal of Clinical Medicine

Carlevale Versus Yamane Sutureless Scleral Fixation: Clinical and Swept-Source AS-OCT Comparative Analysis in Eyes Without Capsular Support

  • Erik Mus1
  • Antonio Valastro1
  • Maura Mancini2
  • Edoardo Bordon3
  • Emanuele Koumantakis4,5
  • Fabio Battaglino1
  • Christine Rollandin6
  • Luca Ventre1
6 affiliations
  1. 1Department of Ophthalmology, Beauregard Hospital, Azienda USL della Valle d’aosta, Via L. Vaccari 5, 11100 Aosta, Italy
  2. 2Department of Biomedical Sciences, Ophthalmology Clinic, University of Messina, 98121 Messina, Italy
  3. 3Faculty of Medicine, University of Turin, 10126 Turin, Italy
  4. 4Center for Biostatistics, Epidemiology, and Public Health, Department of Clinical and Biological Sciences, University of Turin, 10043 Orbassano, Italy
  5. 5Cancer Epidemiology Unit, University Hospital Città della Salute e della Scienza, 10126 Turin, Italy
  6. 6Structure Preventive Medicine and Risk Management, Strategic Management of the Local Health Authority of Valle d’Aosta, 11100 Aosta, Italy
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Abstract

Purpose: We aimed to compare the anatomical and functional outcomes, postoperative complications, and intraocular lens (IOL) positioning of two different techniques of sutureless scleral fixation: the Yamane double-needle flanged technique and the Carlevale intraocular lens. Methods: This retrospective, single-center, comparative observational study included 100 eyes of 100 patients who underwent secondary scleral-fixated IOL implantation between January 2021 and December 2024. Sixty-nine eyes underwent Yamane fixation and 31 eyes received a Carlevale IOL. Best-corrected visual acuity (BCVA), postoperative complications, and anatomical stability were evaluated. In a subgroup of 33 patients, IOL tilt and decentration were objectively assessed at 6 months using second-generation swept-source anterior segment optical coherence tomography (AS-OCT; Casia 2, Tomey, Nagoya, Japan). Results: Both techniques provided significant visual improvements compared with baseline. AS-OCT demonstrated comparable anatomical stability between groups, with mean tilt values of 6.9° and 6.4° and mean decentration values of 0.61 mm and 0.48 mm for the Yamane and Carlevale groups, respectively, without statistically significant differences. Cystoid macular edema was observed numerically more often in the Yamane group (23.1% vs. 15.4% at 6 months; p = 0.604), and anterior chamber blood Tyndall effect was recorded respectively in 13% vs. 6% of eyes; these differences were not statistically significant. Early postoperative complications were generally mild and self-limiting in both groups. Conclusions: Both the Yamane technique and the Carlevale IOL were associated with significant visual improvement and acceptable safety profiles for secondary sutureless scleral fixation in eyes without adequate capsular support. In this sample the Carlevale IOL showed a trend toward better centration, whereas second-generation swept-source AS-OCT proved to be a valuable objective imaging modality for the postoperative evaluation of scleral-fixated IOLs. Larger prospective multicenter studies are needed to confirm these findings.

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Cite

BibTeXRIS
BibTeX
@article{mus2026carlevale,
  title = {{Carlevale Versus Yamane Sutureless Scleral Fixation: Clinical and Swept-Source AS-OCT Comparative Analysis in Eyes Without Capsular Support}},
  author = {Erik Mus and Antonio Valastro and Maura Mancini and Edoardo Bordon and Emanuele Koumantakis and Fabio Battaglino and Christine Rollandin and Luca Ventre},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = nov,
  doi = {10.3390/jcm15218511},
  url = {https://www.mdpi.com/2077-0383/15/21/8511},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Carlevale Versus Yamane Sutureless Scleral Fixation: Clinical and Swept-Source AS-OCT Comparative Analysis in Eyes Without Capsular Support
AU  - Erik Mus
AU  - Antonio Valastro
AU  - Maura Mancini
AU  - Edoardo Bordon
AU  - Emanuele Koumantakis
AU  - Fabio Battaglino
AU  - Christine Rollandin
AU  - Luca Ventre
PY  - 2026
DA  - 2026/11/02
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15218511
UR  - https://www.mdpi.com/2077-0383/15/21/8511
AB  - Purpose: We aimed to compare the anatomical and functional outcomes, postoperative complications, and intraocular lens (IOL) positioning of two different techniques of sutureless scleral fixation: the Yamane double-needle flanged technique and the Carlevale intraocular lens. Methods: This retrospective, single-center, comparative observational study included 100 eyes of 100 patients who underwent secondary scleral-fixated IOL implantation between January 2021 and December 2024. Sixty-nine eyes underwent Yamane fixation and 31 eyes received a Carlevale IOL. Best-corrected visual acuity (BCVA), postoperative complications, and anatomical stability were evaluated. In a subgroup of 33 patients, IOL tilt and decentration were objectively assessed at 6 months using second-generation swept-source anterior segment optical coherence tomography (AS-OCT; Casia 2, Tomey, Nagoya, Japan). Results: Both techniques provided significant visual improvements compared with baseline. AS-OCT demonstrated comparable anatomical stability between groups, with mean tilt values of 6.9° and 6.4° and mean decentration values of 0.61 mm and 0.48 mm for the Yamane and Carlevale groups, respectively, without statistically significant differences. Cystoid macular edema was observed numerically more often in the Yamane group (23.1% vs. 15.4% at 6 months; p = 0.604), and anterior chamber blood Tyndall effect was recorded respectively in 13% vs. 6% of eyes; these differences were not statistically significant. Early postoperative complications were generally mild and self-limiting in both groups. Conclusions: Both the Yamane technique and the Carlevale IOL were associated with significant visual improvement and acceptable safety profiles for secondary sutureless scleral fixation in eyes without adequate capsular support. In this sample the Carlevale IOL showed a trend toward better centration, whereas second-generation swept-source AS-OCT proved to be a valuable objective imaging modality for the postoperative evaluation of scleral-fixated IOLs. Larger prospective multicenter studies are needed to confirm these findings.
SN  - 2077-0383
ER  -