Nair Vidya, Kumar Dhivya Ashok, Prakash Gaurav, Jacob Soosan, Agarwal Athiya, Agarwal Amar
Dr Agarwal's Eye Hospital and Eye Research Centre, Chennai, Tamil Nadu, India.
Eye Contact Lens. 2009 Jul;35(4):215-7. doi: 10.1097/ICL.0b013e3181ac3706.
Management of in-the-bag spontaneous bilateral subluxation of posterior-chamber intraocular lens(PCIOL) with sutureless fibrin-glue-assisted PCIOL implantation.
A patient of retinitis pigmentosa with spontaneous bilateral anterior in-the-bag subluxation of PCIOL was managed by IOL explantation followed by fibrin-glue-assisted sutureless PCIOL implantation. Two partial thickness limbal-based scleral flaps were created about 1.5 mm from the limbus under which sclerotomies were made. Intraocular lens explantation along with capsular bag was performed through the corneo-scleral tunnel incision. Single-piece rigid polymethylmethacrylate 6.5-mm optic IOL was introduced through the limbal wound with a McPherson forceps, both the IOL haptics were externalized under the scleral flap. The haptic ends were tucked in the scleral tunnel made with the 26G needle. Scleral flaps and the conjunctiva were closed with the fibrin glue.
Preoperative best corrected visual acuity was 20/80 in the right and 20/120 in the left eye. Patient gained a best corrected visual acuity of 20/30 in both the eyes, with a bilateral stable PCIOL and clear cornea.
Severe capsular contracture causing in-the-bag IOL subluxation in retinitis pigmentosa can be effectively managed with this new technique of sutureless fibrin-glue-assisted PCIOL implantation.
采用无缝合纤维蛋白胶辅助后房型人工晶状体(PCIOL)植入术治疗囊袋内自发性双侧人工晶状体半脱位。
一名患有色素性视网膜炎且伴有自发性双侧人工晶状体囊袋内前半脱位的患者,先进行人工晶状体取出术,随后采用纤维蛋白胶辅助无缝合人工晶状体植入术。在距角膜缘约1.5mm处制作两个基于角膜缘的部分厚度巩膜瓣,在其下方进行巩膜切口。通过角巩膜隧道切口进行人工晶状体连同囊袋的取出。使用麦克弗森镊经角膜缘伤口植入一片式6.5mm光学区的硬性聚甲基丙烯酸甲酯人工晶状体,人工晶状体的两个襻均置于巩膜瓣下方。襻端插入用26G针头制作的巩膜隧道内。用纤维蛋白胶封闭巩膜瓣和结膜。
术前右眼最佳矫正视力为20/80,左眼为20/120。患者双眼最佳矫正视力均提高到20/30,人工晶状体双侧稳定,角膜透明。
采用这种无缝合纤维蛋白胶辅助人工晶状体植入新技术,可有效治疗色素性视网膜炎中导致囊袋内人工晶状体半脱位的严重囊膜挛缩。