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用于囊袋有缺陷的眼睛的黏附式人工晶状体植入术:解剖学和功能结果的回顾性分析

Glued intraocular lens implantation for eyes with defective capsules: A retrospective analysis of anatomical and functional outcome.

作者信息

Kumar Dhivya A, Agarwal Athiya, Agarwal Amar, Prakash Gaurav, Jacob Soosan

机构信息

Dr. Agarwal's Eye Hospital and Eye Research Centre, Chennai, India.

出版信息

Saudi J Ophthalmol. 2011 Jul;25(3):245-54. doi: 10.1016/j.sjopt.2011.04.001. Epub 2011 Apr 15.

Abstract

PURPOSE

To analyze the anatomical and functional outcome of glued intra ocular lens (IOL) implantation technique and its modifications.

DESIGN

Retrospective observational case series.

METHODS

This is a retrospective analysis of the patients who underwent glued intra ocular lens implantation from December 2007 to August 2010. Post operative uncorrected vision, best corrected visual acuity (BCVA), intra ocular pressure, IOL position, endothelial cells and anterior chamber reaction at their last follow up are analyzed from their concerned case sheets documentation. Subjective changes are analyzed via individual questionnaire. Immediate and late postoperative complications are also evaluated. Surgical modifications and the difference in the operated eyes are analyzed.

RESULTS

Total 210 glued IOL eyes have been reviewed. Out of this 210, there are 152 (PMMA glued IOL), 21 (three piece foldable IOL), 5 (multifocal foldable IOL), 12 (pediatric glued IOL), 5 (20G sutureless vitrectomy), 2 (glued iris prosthesis) and 3 (transposition of posterior chamber IOL into anterior chamber). In combined surgeries there are, 5 (optical penetrating keratoplasty), 2 (descemet's stripping endothelial keratoplasty) and 3 (iridoplasty). The modifications in glued IOL are handshake technique, injectable or foldable glued IOL, Multifocal glued IOL and intraoperative 23/25G trocar cannula infusion. Decentration (1.97%), macular edema (1.97%) and optic capture (2.63%) are the post operative complications encountered in rigid glued IOL. Good patient satisfaction is seen in the eyes with IOL repositioning, IOL exchange and multifocal glued IOL. There is significant improvement in BCVA in PMMA IOL (p = 1.35 × 10(-5)) and foldable IOL (p = 0.000).

CONCLUSION

Glued IOL seems to be a good alternative in IOL implantation in eyes with deficient capsules. The modifications in the existing technique decrease the learning time and risk for complications.

摘要

目的

分析黏附式人工晶状体(IOL)植入技术及其改良方法的解剖学和功能结果。

设计

回顾性观察病例系列。

方法

这是一项对2007年12月至2010年8月期间接受黏附式人工晶状体植入术的患者的回顾性分析。从相关病历记录中分析其最后一次随访时的术后未矫正视力、最佳矫正视力(BCVA)、眼压、人工晶状体位置、内皮细胞和前房反应。通过个人问卷分析主观变化。还评估了术后即刻和晚期并发症。分析手术改良方法以及手术眼之间的差异。

结果

共回顾了210只接受黏附式人工晶状体植入的眼睛。其中,152只(PMMA黏附式人工晶状体)、21只(三片式可折叠人工晶状体)、5只(多焦点可折叠人工晶状体)、12只(儿童黏附式人工晶状体)、5只(20G无缝合玻璃体切除术)、2只(黏附式虹膜假体)和3只(后房型人工晶状体向前房移位)。在联合手术中,有5只(光学穿透性角膜移植术)、2只(Descemet膜剥脱内皮角膜移植术)和3只(虹膜成形术)。黏附式人工晶状体的改良方法有握手技术、可注射或可折叠黏附式人工晶状体、多焦点黏附式人工晶状体和术中23/25G套管针输注。偏心(1.97%)、黄斑水肿(1.97%)和光学捕获(2.63%)是刚性黏附式人工晶状体术后遇到的并发症。人工晶状体重新定位、人工晶状体置换和多焦点黏附式人工晶状体的患者满意度良好。PMMA人工晶状体(p = 1.35 × 10(-5))和可折叠人工晶状体(p = 0.000)的BCVA有显著改善。

结论

黏附式人工晶状体似乎是囊袋不足的眼睛中人工晶状体植入的一种良好选择。现有技术的改良减少了学习时间和并发症风险。

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