Ganesh Anuradha, Al-Zuhaibi Sana, Mitra Sandip, Sabt Buthaina I Saad, Ganguly Shyam S, Bialasiewicz Alexander A
Department of Ophthalmology, Sultan Qaboos University College of Medicine and Health Sciences, Muscat, Oman.
Ophthalmic Surg Lasers Imaging. 2009 Jul-Aug;40(4):354-60. doi: 10.3928/15428877-20096030-01.
To report indications and outcomes of scleral-fixated posterior chamber intraocular lenses (PC IOLs) in Omani children with aphakia.
Patients with aphakia who were younger than 16 years, unsuitable for spectacle or contact lens correction, and without capsular support underwent an anterior vitrectomy and 10-0 polypropylene inside-out scleral fixation ofa PC IOL.
Scleral-fixated PC IOLs were implanted in 28 eyes of 24 patients. Group A comprised 10 (36%) eyes with congenital cataract and 3 (11%) eyes with ectopia lentis and group B comprised 15 (53%) eyes with traumatic cataract. The mean age at implantation was higher in group A (10.5 years) than in group B (7.3 years). Visual acuity improved in 17 of 28 (61%) eyes and remained at the preoperative levels in 11 of 28 (39%) eyes. Mean postoperative refraction was within +/- 2.0 diopters of the predicted refraction in 19 of 28 (68%) eyes. Complications included temporary intraocular pressure increase, vitreous hemorrhage, and iris capture with lens malposition.
Scleral-fixated PC IOLs are beneficial for children with aphakia without posterior capsular support who are lacking other means for visual rehabilitation. Patients with traumatic cataract and lens dislocation are more likely to experience an improvement in visual acuity postoperatively than patients with congenital cataract. However, this procedure is technically more difficult than routine PC IOL implantation and potentially carries greater risks.
报告在阿曼无晶状体儿童中巩膜固定后房型人工晶状体（PC IOL）的适应证及治疗效果。
年龄小于16岁、不适合佩戴眼镜或隐形眼镜矫正且无晶状体囊膜支撑的无晶状体患者接受了前部玻璃体切除术，并使用10-0聚丙烯缝线进行后房型人工晶状体的巩膜内固定术。
24例患者的28只眼植入了巩膜固定后房型人工晶状体。A组包括10只（36%）先天性白内障眼和3只（11%）晶状体异位眼，B组包括15只（53%）外伤性白内障眼。A组植入时的平均年龄（10.5岁）高于B组（7.3岁）。28只眼中17只（61%）视力改善，28只眼中11只（39%）视力维持在术前水平。28只眼中19只（68%）术后平均屈光不正度数在预测值的±2.0屈光度范围内。并发症包括眼压暂时升高、玻璃体出血和晶状体位置异常伴虹膜夹持。
巩膜固定后房型人工晶状体对无晶状体囊膜支撑且缺乏其他视力康复手段的儿童有益。外伤性白内障和晶状体脱位患者术后视力改善的可能性比先天性白内障患者更大。然而，该手术在技术上比常规后房型人工晶状体植入更困难，且潜在风险更大。
