Moreno-Montañés Javier, Sainz Carmen, Maldonado Miguel J
Departamento de Oftalmología, Clínica Universitaria de Navarra, Universidad de Navarra, Pamplona, Spain.
J Cataract Refract Surg. 2003 Mar;29(3):492-7. doi: 10.1016/s0886-3350(02)01604-8.
To analyze the intraoperative and postoperative complications of Cionni ring implantation in eyes with a subluxated lens or zonular weakness.
Departamento de Oftalmología, Clínica Universitaria de Navarra, Universidad de Navarra, Pamplona, Spain.
This case series comprised 7 eyes of 5 patients with a subluxated lens or zonular weakness secondary to Marfan's syndrome (n = 2), traumatic cataract (n = 2), or megalocornea (n = 1) or of unknown etiology (n = 2). An AcrySof (Alcon) foldable intraocular lens (IOL) was implanted in all eyes. A 2-eyelet Cionni ring was implanted in 1 eye and a 1-eyelet Cionni ring, in 6 eyes. The Cionni ring was secured in position with a transscleral suture knotted to the ring's hook, avoiding peripheral perforation of the capsular bag.
In 1 eye, corectopia was inadvertently produced by passing the suture needle through the iris root; lens subluxation temporarily increased during ring rotation and implantation. However, after the transscleral suture was tightened, capsular bag centration was excellent. In the eye with megalocornea, traction from the 2 hooks tore the edge of the anterior capsule rim. The most frequent postoperative complication was posterior capsule opacification, which occurred in 5 eyes, 2 of which required a neodymium:YAG posterior capsulotomy. After 1 year, the Cionni ring continued to provide excellent stability and capsular bag and IOL positioning in all cases.
Results indicate that Cionni ring implantation is an acceptable procedure to correct limited lens subluxation, preserves the capsular bag, and has few significant complications.
分析在晶状体半脱位或悬韧带薄弱的眼中植入Cionni环的术中及术后并发症。
西班牙潘普洛纳市纳瓦拉大学纳瓦拉大学临床医院眼科。
该病例系列包括5例患者的7只眼,这些患者患有继发于马凡综合征(n = 2)、外伤性白内障(n = 2)、大角膜(n = 1)或病因不明(n = 2)的晶状体半脱位或悬韧带薄弱。所有眼中均植入了爱尔康(Alcon)的AcrySof可折叠人工晶状体(IOL)。1只眼中植入了两眼孔Cionni环,6只眼中植入了单眼孔Cionni环。通过将经巩膜缝线与环的挂钩打结,将Cionni环固定在位,避免囊袋周边穿孔。
在1只眼中,缝线针穿过虹膜根部时意外导致瞳孔异位;在环旋转和植入过程中晶状体半脱位暂时加重。然而,在收紧经巩膜缝线后,囊袋对中良好。在患有大角膜的眼中,两个挂钩的牵引力撕裂了前囊边缘。最常见的术后并发症是后囊混浊,5只眼出现该并发症,其中2只眼需要进行钕:钇铝石榴石激光后囊切开术。1年后,在所有病例中Cionni环继续提供出色的稳定性以及囊袋和人工晶状体的定位。
结果表明,植入Cionni环是纠正有限晶状体半脱位的可接受方法,可保留囊袋,且并发症较少。