Sewelam Ashraf
Mansoura Ophthalmic Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
J Cataract Refract Surg. 2003 Feb;29(2):294-300. doi: 10.1016/s0886-3350(02)01531-6.
To evaluate the results of 4-point scleral fixation of posterior chamber intraocular lenses (PC IOLs) in children.
Mansoura Ophthalmic Center, Mansoura University, Mansoura, Egypt.
This retrospective study comprised 20 aphakic eyes of 20 children. Preoperative investigations proved the absence of adequate posterior capsule support. All patients had ab externo 4-point scleral fixation of a PC IOL. All preoperative and postoperative data were studied and analyzed.
The mean preoperative age was 7.7 years (range 4 to 11 years). The mean follow-up was 19.35 months (range 13 to 30 months). The preoperative findings included a best corrected visual acuity of 6/18 or better in 8 eyes (40%), corneal scarring in 18 eyes, sector iridectomy in 7 eyes, and after-cataract in 4 eyes. The intraoperative complications included vitreous hemorrhage in 2 eyes and slippage of 1 suture in 1 eye. Postoperative complications included mild anterior uveitis in 12 eyes and severe fibrinoid reaction in the anterior chamber in 8 eyes. There were no cases of suture exposure, IOL malpositioning, or infection. Twelve patients (60%) had a visual acuity of 6/18 or better. The cause of the poor visual outcome in many patients was preexisting amblyopia.
The results suggest that 4-point scleral fixation is an option to correct aphakia in children. However, long-term follow-up is important to assess the procedure's safety.
评估儿童后房型人工晶状体（PC IOL）四点巩膜固定术的效果。
埃及曼苏拉曼苏拉大学曼苏拉眼科中心。
这项回顾性研究纳入了20例儿童的20只无晶状体眼。术前检查证实缺乏足够的后囊膜支撑。所有患者均接受了PC IOL的外路四点巩膜固定术。对所有术前和术后数据进行了研究和分析。
术前平均年龄为7.7岁（范围4至11岁）。平均随访时间为19.35个月（范围13至30个月）。术前检查结果包括8只眼（40%）最佳矫正视力为6/18或更好，18只眼角膜瘢痕，7只眼扇形虹膜切除术，4只眼后发性白内障。术中并发症包括2只眼玻璃体积血和1只眼1根缝线滑脱。术后并发症包括12只眼轻度前葡萄膜炎和8只眼前房严重纤维蛋白样反应。没有缝线暴露、人工晶状体位置异常或感染的病例。12例患者（60%）视力为6/18或更好。许多患者视力不佳的原因是存在弱视。
结果表明，四点巩膜固定术是矫正儿童无晶状体眼的一种选择。然而，长期随访对于评估该手术的安全性很重要。
