Kanigowska Krystyna, Grałek Mirosława, Karczmarewicz Beata
Kliniki Okulistyki Instytutu Pomnik, Centrum Zdrowia Dziecka w Warszawie.
Klin Oczna. 2007;109(7-9):283-6.
To report the long-term surgical complications of transscleral sutured intraocular lens implantation in children.
Surgical procedure was performed in 10 children (17 eyes) with ectopia lentis, and in 16 children (21 eyes) with aphakia between July 1995 and December 1998. The mean age of implantation was 8.1 years (range 4 to 17). The Lewis method ab externo was used to suture 1-piece PMMA IOL in all cases. Average follow-up was 9.1 years (range 8 to 11 years).
After operation in long time observations, we noted retinal detachment in 1 eye (post trauma), suture break and IOL dislocation in 3 eyes, suture erosion through the scleral flap in 4 eyes, suture erosion through the flap and conjuctiva in 2 eyes, IOL decentraction in 3 eyes, IOL tilt in 6 eyes, glaucoma in 2 eyes, anterior uveitis in 2 eyes. Four eyes exhibited episodes of iris capture of the IOL optic. There were no endophthalmitis in this group of patients.
The analysis showed that long follow up and complications was associated with scleral fixation included exposure of the scleral suture and the suture break, not with retinal detachment and endophthalmitis.
报告儿童经巩膜缝合人工晶状体植入术的长期手术并发症。
1995年7月至1998年12月期间，对10例（17只眼）晶状体异位儿童和16例（21只眼）无晶状体儿童进行了手术。植入的平均年龄为8.1岁（范围4至17岁）。所有病例均采用Lewis外路法缝合单片式聚甲基丙烯酸甲酯人工晶状体。平均随访时间为9.1年（范围8至11年）。
经过长时间观察术后情况，我们发现1只眼（外伤后）发生视网膜脱离，3只眼出现缝线断裂和人工晶状体脱位，4只眼的缝线穿过巩膜瓣发生侵蚀，2只眼的缝线穿过瓣和结膜发生侵蚀，3只眼人工晶状体偏心，6只眼人工晶状体倾斜，2只眼发生青光眼，2只眼发生前葡萄膜炎。4只眼出现人工晶状体光学部被虹膜捕获的情况。该组患者未发生眼内炎。
分析表明，长期随访及并发症与巩膜固定有关，包括巩膜缝线暴露和缝线断裂，而非视网膜脱离和眼内炎。
