The Yamane technique is a sutureless method of fixing an intraocular lens to the sclera (the white wall of the eye) when the natural capsule can no longer support it. It is used for a dislocated or subluxated IOL, or for aphakia (no lens) after complicated cataract surgery or trauma. At our partner clinics, scleral-fixated IOL surgery starts from around £5,000 per eye, with a typical range of £4,500–£8,000 depending on complexity and whether a vitrectomy is needed at the same time.
When is scleral fixation needed?
Most intraocular lenses sit inside the natural capsular bag left behind after cataract surgery. Sometimes that support fails — the lens and capsule can shift out of position years later, particularly in eyes with pseudoexfoliation, high myopia, previous trauma or previous vitreoretinal surgery. The result is a dislocated or subluxated IOL: blurred or double vision, glare, and the sense that the lens is “moving”.
When there is not enough capsule to reposition the lens in the usual way, the IOL must be anchored directly to the wall of the eye. The Yamane technique does this without stitches, using the lens’s own haptics (arms) sealed into the sclera. It is also used to implant a brand-new lens in an eye that has been left aphakic. Related procedures include IOL exchange and, where the capsule is intact, standard cataract surgery.
How a lens can be fixated
When the capsule cannot hold a lens, your surgeon will recommend the safest, most stable option for your eye:
Your consultant will examine the lens position, the state of the iris and retina, and any need for a vitreoretinal procedure before recommending the approach. Browse the full range of implant lens options.
What happens during Yamane surgery
Surgery is performed under local or general anaesthetic as a day case and usually takes 45–90 minutes.
- The dislocated lens or capsule is removed if it cannot be reused, often with a small vitrectomy to clear the gel from the back of the eye.
- Two tiny angled tunnels are made in the sclera, a precise distance apart, using thin-walled needles.
- The haptics of a three-piece IOL are threaded into these needles and externalised through the sclera.
- The very tips of the haptics are melted with low-temperature cautery to form small flanges, which are tucked back and lock the lens securely against the eye wall.
- The lens is checked for centration and stability, and the incisions — which are self-sealing — are closed without stitches.
Vision unstable after cataract surgery or an old lens implant? A consultant assessment will confirm whether the lens has dislocated and how best to secure it.
Book an assessmentRecovery week-by-week
Day of surgery
Eye shielded, vision hazy. Rest at home. Drops begin. No driving or heavy lifting.
Days 1–7
Vision begins to clear; mild ache or grittiness settles. First post-op review in this period.
Weeks 2–4
Vision steadies as the eye heals. Drops continue on a reducing schedule. Most return to normal activities.
Beyond a month
Lens position is stable and vision settled. Any new glasses prescription is finalised at the final review.
Because the lens is anchored to the eye wall rather than free-floating, most patients regain clear, stable vision. If clouding of a residual membrane develops later, a quick YAG laser capsulotomy can treat it.
Scleral-fixated IOL surgery cost
Our prices are all-inclusive of the consultant surgeon, theatre and day-case admission, the replacement intraocular lens, post-operative drops and follow-up reviews.
- Self-pay: from around £5,000 per eye, typically £4,500–£8,000 depending on complexity.
- Combined vitrectomy: where the gel must be cleared at the same time, cost is at the higher end of the range.
- Insurance: often covered as a medically necessary procedure — we can help with authorisation.
For lens choices and other lens-replacement pricing, see implant lenses and refractive lens exchange.