Augenzentrum Recklinghausen, Recklinghausen, Germany.
J Refract Surg. 2011 May;27(5):386-8. doi: 10.3928/1081597X-20110106-02. Epub 2011 Jan 17.
To present a technique for sutureless fixation of a three-piece, multifocal, posterior chamber intraocular lens (IOL) in the ciliary sulcus.
A 24-year-old woman presented with bilateral subluxation of the crystalline lens. Two straight sclerotomies were prepared with a 24-gauge cannula 2.0 mm from the limbus 180° apart from each other. The cannula was used to create a 2.0- to 3.0-mm tunnel parallel to the limbus starting from the sclerotomies. The leading haptic of the multifocal IOL was grasped at its tip with end-gripping, 25-gauge forceps and pulled through the sclerotomy. The forceps was used to introduce the IOL haptic into the scleral tunnel parallel to the limbus.
Multifocal posterior chamber IOLs were stable and well centered. No postoperative complications occurred in the 16-month follow-up period. Preoperative astigmatism was corrected after IOL implantation with corneal wavefront-guided laser epithelial keratomileusis.
Sutureless fixation of multifocal posterior chamber IOL haptics in a scleral tunnel parallel to the limbus can be successful, resulting in long-term centration and three-dimensional axial stability for optimal refractive results. If necessary, postoperative wavefront-guided refractive correction can be performed to optimize final refraction.
介绍一种在后房三焦点人工晶状体（IOL）睫状沟无缝线固定的技术。
一名 24 岁女性双侧晶状体半脱位。在距角膜缘 2.0mm 处，用 24 号套管针制备两个直的巩膜隧道，彼此相距 180°。套管针用于从巩膜隧道开始，平行于角膜缘制作 2.0-3.0mm 的隧道。用末端夹持 25 号镊子夹住多焦点 IOL 的主导线，将其尖端拉出巩膜隧道。用镊子将 IOL 襻平行于角膜缘引入巩膜隧道。
多焦点后房 IOL 稳定且居中良好。在 16 个月的随访期间，没有发生术后并发症。在 IOL 植入后，通过角膜波前引导的激光上皮下角膜磨镶术矫正术前散光。
在平行于角膜缘的巩膜隧道中进行多焦点后房 IOL 襻的无缝线固定是成功的，可实现长期的中心定位和三维轴向稳定性，从而获得最佳的屈光效果。如果需要，可进行术后波前引导的屈光矫正，以优化最终的屈光度。
