Complex cataract surgery presents unique challenges when capsular support is absent or compromised by trauma, pseudoexfoliation or prior intraocular surgery.
Over the past decade, refinements in IOL fixation techniques, including scleral-sutured, Yamane-type intrascleral, iris-claw (enclavated) and piggyback IOL implantation, have expanded management options for aphakia and IOL dislocation (Beutner et al.). These approaches aim to balance long-term stability, refractive accuracy and ocular safety while minimizing postoperative complications such as tilt, decentration, cystoid macular edema and