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视网膜脱离手术后虹膜固定型有晶状体眼人工晶状体植入:长期临床结果。

Iris-fixated phakic intraocular lens implantation after retinal detachment surgery: long-term clinical results.

机构信息

From the Department of Ophthalmology (Chung, S.J. Lee), Soonchunhyang University, College of Medicine, and the Balgensesang Ophthalmology Clinic (Kim), Seoul, and Bundang Yonsei Plus Eye Clinic (J.B. Lee), Sungnam, South Korea.

出版信息

J Cataract Refract Surg. 2013 Oct;39(10):1494-501. doi: 10.1016/j.jcrs.2013.04.037. Epub 2013 Aug 20.

Abstract

PURPOSE

To assess the efficacy and safety of iris-fixated phakic intraocular lens (pIOL) implantation to correct myopia in eyes with previous retinal detachment (RD) surgery.

SETTING

Department of Ophthalmology, Soonchunhyang University College of Medicine, Seoul, South Korea.

DESIGN

Retrospective case series.

METHODS

Patients having pIOL implantation in both eyes were enrolled. Eyes that had scleral buckling or encircling (RD group) and healthy fellow eyes (non-RD group) were evaluated over a 6-year follow-up. The corrected distance visual acuity (CDVA), endothelial cell density (ECD), intraoperative complications, and long-term complications were safety outcomes. Uncorrected distance visual acuity (UDVA), predictability, and stability of refraction were efficacy outcomes.

RESULTS

The study comprised 34 eyes (17 patients). The mean postoperative CDVA and ECD were not significantly different between groups, and no patient lost CDVA. The rate of transient intraocular pressure spike was significantly higher in the RD group (P=.043). After 3 years and 6 years, the mean postoperative UDVA was 0.06 logMAR ± 0.09 (SD) and 0.08 ± 0.10 logMAR, respectively, in the RD group and 0.04 ± 0.08 logMAR and 0.04 ± 0.09 logMAR, respectively, in the non-RD group (P=.518 and P=.478, respectively). The rate of eyes within ±0.50 diopter of the desired refraction and the postoperative refraction was not significantly different between groups. No eye had vitreoretinal changes requiring secondary surgical intervention.

CONCLUSION

Iris-fixated pIOL implantation corrected the myopic refractive error in patients who had scleral buckling or encircling surgery for RD with a high degree of efficacy, safety, and long-term stability.

FINANCIAL DISCLOSURE

No author has a financial or proprietary interest in any material or method mentioned.

摘要

目的

评估虹膜固定型有晶状体眼人工晶状体(pIOL)植入术矫正既往视网膜脱离(RD)手术后近视的疗效和安全性。

设置

韩国首尔顺天乡大学医学院眼科。

设计

回顾性病例系列。

方法

招募了接受双眼 pIOL 植入术的患者。评估了接受巩膜扣带术或环扎术(RD 组)和健康对侧眼(非 RD 组)的患者,随访时间为 6 年。矫正后视力(CDVA)、内皮细胞密度(ECD)、术中并发症和长期并发症是安全性结果。未矫正远视力(UDVA)、预测性和屈光稳定性是有效性结果。

结果

本研究包括 34 只眼(17 例)。两组间术后 CDVA 和 ECD 无显著差异,且无患者丧失 CDVA。RD 组眼压升高的发生率明显较高(P=.043)。术后 3 年和 6 年,RD 组平均术后 UDVA 分别为 0.06 对数视力(logMAR)±0.09(标准差)和 0.08±0.10 logMAR,而非 RD 组分别为 0.04±0.08 logMAR 和 0.04±0.09 logMAR(P=.518 和 P=.478)。两组间期望屈光度±0.50 屈光度的眼数和术后屈光度无显著差异。无眼发生需要二次手术干预的玻璃体视网膜病变。

结论

虹膜固定型 pIOL 植入术可有效、安全、长期稳定地矫正接受巩膜扣带术或环扎术治疗 RD 后近视患者的近视屈光不正。

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