Yarangumeli Alper, Alp Mehmet Numan, Kural Gulcan
Department of Ophthalmology, Ankara Numune Training and Research Hospital, Ankara, Turkey.
Eur J Ophthalmol. 2012 Jul-Aug;22(4):547-53. doi: 10.5301/ejo.5000094.
To evaluate the results of single-suture scleral fixation of subluxated foldable intraocular lenses (IOL) in eyes with sufficient residual capsular support.
The results of IOL repositioning by single-suture scleral fixation in 6 eyes of 6 patients with IOL subluxation were included. All subluxated IOLs were single-piece hydrophilic acrylic. Subluxation resulted from posterior capsule tears in 3 eyes, zonular dialyses in 2 eyes, and zonular dialysis with a capsulorhexis tear in 1 eye. A similar technique was used in all eyes in which one haptic was externalized through a superior clear corneal incision and tied with a Pair-PAK 10-0 polypropylene suture, and was finally retracted and fixated behind the iris close to the ciliary sulcus at the 12:00 meridian. All patients were followed up for at least 6 months.
Best-corrected visual acuities ranged between finger counting and 20/70 (mean logMAR 1.02±0.64) preoperatively, and between 20/100 and 20/20 (mean logMAR 0.22±0.26) at the final postoperative visit. All IOLs remained centered and no significant postoperative complications were encountered except for an IOL tilt which resulted in a considerable oblique astigmatism in one eye.
Subluxated foldable IOLs may safely be repositioned and secured with a single scleral fixation suture in selected cases with adequate amount of capsular remnants.
评估在具有足够残余囊膜支撑的眼中,对半脱位的可折叠人工晶状体(IOL)进行单缝线巩膜固定术的效果。
纳入6例IOL半脱位患者的6只眼行单缝线巩膜固定IOL复位术的结果。所有半脱位的IOL均为单片式亲水性丙烯酸酯。3只眼因后囊膜撕裂导致半脱位,2只眼因悬韧带离断,1只眼因悬韧带离断合并撕囊口撕裂导致半脱位。所有眼均采用类似技术,通过上方透明角膜切口将一个袢引出,用Pair-PAK 10-0聚丙烯缝线结扎,最后将其回退并固定于虹膜后靠近12点子午线的睫状沟处。所有患者均随访至少6个月。
术前最佳矫正视力在眼前手动至20/70之间(平均logMAR 1.02±0.64),术后末次随访时在20/100至20/20之间(平均logMAR 0.22±0.26)。所有IOL均保持居中,除1只眼IOL倾斜导致明显的斜向散光外,未出现明显的术后并发症。
在有足够囊膜残余的特定病例中,半脱位的可折叠IOL可通过单巩膜固定缝线安全地重新定位并固定。