Evaluation of anterior segment structures after scleral fixation surgery

Purpose: This prospective study aimed to comprehensively evaluate the effects of scleral fixation surgery using the modified Yamane technique on visual acuity, intraocular pressure , corneal topographic parameters, and endothelial cell health. Materials and Methods: The study included 34 eyes of 34 patients who underwent scleral fixation surgery due to insufficient capsular support at Harran University Ophthalmology Clinic. The study was designed prospectively. Patients were divided into three groups: scleral fixation (aphakia), combined phacoemulsification with scleral fixation, and combined intraocular lens exchange with scleral fixation. Best-corrected visual acuity , intraocular pressure, corneal topography (Pentacam), specular microscopy (Nidek CEM-530), and other anterior segment parameters were assessed preoperatively and at 1 and 3 months postoperatively. Statistical analyses were performed using SPSS 28.0. Results: Best-corrected visual acuity significantly improved at 1 and 3 months postoperatively. Intraocular pressure remained generally unchanged, but a significant decrease was observed in the phacoemulsification group. Corneal topographic parameters (Belin/Ambrosio index, Q-value, K1, K2, Km) showed no significant changes; however, Kmax and anterior corneal astigmatism significantly increased in the phacoemulsification group at 1 month . Corneal volume significantly increased at 1 month in the overall group and the phacoemulsification group. Anterior chamber volume and iridocorneal angle significantly increased in the phacoemulsification group. Endothelial cell count, hexagonality, and coefficient of variation showed significant changes in all groups , with greater endothelial loss in the phacoemulsification group. Conclusion: Scleral fixation surgery using the modified Yamane technique improved visual acuity with minimal changes in corneal topographic parameters. Combined phacoemulsification with scleral fixation had more pronounced effects on anterior segment parameters and endothelial health. This prospective study contributes to the limited literature evaluating the effects of scleral fixation on anterior segment structures.