Lanzetta P, Bandello F M, Virgili G, Crovato S, Menchini U
Department of Ophthalmology, University of Udine, Italy.
Doc Ophthalmol. 1999;97(3-4):317-24. doi: 10.1023/a:1002190223882.
No consensus currently exists on the optimal method for intraocular (IOL) implantation without capsular support. We evaluated the outcome and angiographic findings of eyes that underwent the implantation of scleral fixated IOLs.
Iris and retinal fluorescein angiography were performed in 13 eyes that had received posterior chamber IOL implantation with scleral fixation. Follow-up examinations also assessed visual acuity (VA), intraocular pressure (IOP), IOL decentration and complications related to the procedure.
Mean visual acuity was 0.29 preoperatively and 0.71 postoperatively after a mean follow-up of 14.2 months. A best corrected visual acuity of 0.5 or better was obtained in 12 eyes. Iris fluorescein angiography did not show major vascular abnormalities. Retinal angiography showed 5 cases of macular edema. In 6 eyes light-induced retinal lesions occurred. Cellophane maculopathy was disclosed in 4 eyes. Macular edema was associated with photic injury in 4 cases and with cellophane maculopathy in 2 cases. Mean postoperative visual acuity was 0.6 in eyes with macular edema and 0.88 in eyes without (SD 0.18; range 0.5-1.0). Four of 5 eyes with macular edema had a postoperative visual acuity of 0.5 or better. There was no evidence of persistent IOP elevation or IOL decentration. No serious complications were recorded during surgery.
Transscleral fixation of posterior chamber IOLs provides adequate visual acuity in most patients. Macular edema was frequently associated with the procedure. Although this complication was a cause of low visual recovery after implantation, the majority of eyes with macular edema achieved a visual acuity of 0.5 or better. Light-induced retinal injury was a permanent complication.
目前对于无晶状体囊膜支撑的眼内（IOL）植入的最佳方法尚无共识。我们评估了接受巩膜固定型人工晶状体植入术的眼睛的手术效果及血管造影结果。
对13只接受巩膜固定后房型人工晶状体植入术的眼睛进行了虹膜和视网膜荧光素血管造影。随访检查还评估了视力（VA）、眼压（IOP）、人工晶状体偏心以及与手术相关的并发症。
平均随访14.2个月，术前平均视力为0.29，术后为0.71。12只眼的最佳矫正视力达到0.5或更好。虹膜荧光素血管造影未显示主要血管异常。视网膜血管造影显示5例黄斑水肿。6只眼发生了光诱导性视网膜病变。4只眼发现了玻璃纸样黄斑病变。黄斑水肿在4例中与光损伤有关，在2例中与玻璃纸样黄斑病变有关。黄斑水肿眼的术后平均视力为0.6，无黄斑水肿眼为0.88（标准差0.18；范围0.5 - 1.0）。5例黄斑水肿眼中有4例术后视力达到0.5或更好。没有证据表明眼压持续升高或人工晶状体偏心。手术期间未记录到严重并发症。
后房型人工晶状体的巩膜固定术在大多数患者中提供了足够的视力。黄斑水肿经常与该手术相关。尽管这种并发症是植入术后视力恢复不佳的一个原因，但大多数黄斑水肿眼的视力达到了0.5或更好。光诱导性视网膜损伤是一种永久性并发症。
