Light Adjustable Lens (LAL) using Yamane intrascleral flanged fixation for traumatic aphakia: A case report

Purpose: To describe the novel use of a Light Adjustable Lens (LAL) implanted using Yamane flanged intrascleral fixation for the management of post-traumatic aphakia without capsular support.

Observations: A 60-year-old male presented with aphakia in the right eye following remote ocular trauma during adolescence. Preoperative corrected distance visual acuity was 20/70 with a hyperopic refraction of +9.00 + 3.50 × 87. Biometry revealed high corneal astigmatism (4.43 diopters) and an axial length of 23.52 mm. In the absence of capsular support, a +19.5 D LAL was implanted using the Yamane double-needle flanged intrascleral fixation technique. Postoperatively, the patient underwent four light-delivery treatments over 14 weeks. By week 14, corrected distance visual acuity improved to 20/40-2 with uncorrected distance visual acuity of 20/70-2. Final manifest refraction was 0.00 -2.50 × 180, achieving excellent binocular alignment with the fellow eye. The lens remained well centered throughout follow-up, with no intraoperative or postoperative complications such as cystoid macular edema or elevated intraocular pressure.