الفهرس 
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Abstract
In this prospective study, we evaluated the safety and efficacy of a modified flanged ISHF (Modified Yamane technique). Patients with surgical aphakia, traumatic aphakia and IOL/lens subluxation or dislocation who met the inclusion criteria were enrolled in the study. Patients with other pathology that may affect the visual outcome were excluded. Amblyopic eyes also were excluded from the study. The studied patients were evaluated at 1, 3 and 6 months postoperatively. We assessed UCDVA, CDVA, spherical equivalent and IOP. ECC, keratometric readings and central corneal thickness were also measured. IOLs were carefully examined for stability, centralization, tilt, or capture. IOL-induced astigmatism was calculated. We also gave a great concern for any possible post-operative complications with successful management throughout the follow up period. The mean age of patients was 45 years. Twenty eyes were enrolled in our study. Ten eyes with surgical aphakia, four with traumatic aphakia, four had subluxated IOL/bag complex, one had dislocated IOL and the last one had posterior dislocated lens. The UCDVA showed significant improvement at all follow-up visits compared to preoperative values. The mean CDVA was 0.3 Log MAR 6 months postoperatively. The mean spherical equivalent showed significant reduction postoperatively. The mean spherical equivalent was -0.5 D 6 months postoperatively. Statistically but not clinically significant reduction in the mean ECC was reported. There was no statistically significant difference in the mean central corneal thickness, corneal astigmatism or keratometric readings between the preoperative and postoperative readings. The IOLs were fixed with good centration and axial stability. Five eyes have decentred IOL which did not affect vision in four of them. Significant tilt occurred in two eyes and only one required repositioning. Optic capture noticed in one eye. The mean IOL- induced astigmatism was -0.75 D. Our study also showed that both early and late post-operative complications occurred in eyes with traumatic aphakia following rupture of the globe. Conclusion : Although long-term follow up is not available, flapless and sutureless technique is an elegant method for ISHF with a new strategy of securing haptics to sclera, by melting haptics to create a flange. It carried out a favourable surgical outcome and limited post-operative complications. Flapless and sutureless technique proved to be a suitable choice for intrascleral fixation of PC IOL in absence of capsular support, as it has advantages, including eliminating the need for sutures, glue, and scleral or conjunctival dissection with minimal surgical trauma, good IOL stabilization and a relatively shorter operation time.