Cho Yong-Wun, Chung In-Young, Yoo Ji-Myong, Kim Seong-Jae
Department of Ophthalmology, Gyeongsang National University College of Medicine, Jinju, Korea.
Department of Ophthalmology, Gyeongsang National University College of Medicine, Jinju, Korea. ; Gyeongsang Institute of Health Science, Gyeongsang National University, Jinju, Korea.
Korean J Ophthalmol. 2014 Apr;28(2):181-5. doi: 10.3341/kjo.2014.28.2.181. Epub 2014 Mar 14.
In this case series, we assessed a new technique, the intrascleral pocket procedure of transscleral fixation (TF) of the intraocular lens (IOL) in post-vitrectomized eyes. We performed the transscleral fixation of IOL in four aphakic patients who underwent pars plana vitrectomy. Two points 180° apart were marked at the limbus. A 2-mm-sized intrascleral pocket was created by lamellar dissection using a crescent blade without conjunctival dissection. A 2.8-mm clear corneal incision (CCI) was made using a keratome. Prolene sutures were exteriorized through the CCI pocket and a three-piece foldable acrylic IOL was injected via CCI and the ends of the haptics were exteriorized through the CCI. The prolene sutures for each haptic in the intrascleral pocket bed were then tied and knots were buried under scleral flaps. No patient had complaints such as conjunctival irritation, and visual acuity was almost identical to preoperative best-corrected visual acuity at day 1 postoperatively. IOLs were well placed without tilting or subluxation. They had no wound dehiscence or endophthalmitis postoperatively. The intrascleral pocket procedure of TF without the need for conjunctival dissection is a successful method for sulcus fixation in post-vitrectomized eyes predisposed to developing glaucoma.
在本病例系列中,我们评估了一种新技术,即玻璃体切除术后眼内人工晶状体(IOL)经巩膜固定(TF)的巩膜内囊袋手术。我们对4例接受了平坦部玻璃体切除术的无晶状体患者进行了IOL经巩膜固定术。在角膜缘标记相距180°的两点。使用新月形刀片进行板层分离创建一个2毫米大小的巩膜内囊袋,无需进行结膜分离。使用角膜刀制作一个2.8毫米的透明角膜切口(CCI)。普理灵缝线经CCI切口引出,通过CCI注入一片式可折叠丙烯酸IOL,其襻的末端经CCI引出。然后在巩膜内囊袋床中系紧每个襻的普理灵缝线,并将结埋于巩膜瓣下。无患者出现结膜刺激等不适,术后第1天视力几乎与术前最佳矫正视力相同。IOL位置良好,无倾斜或半脱位。术后未出现伤口裂开或眼内炎。无需结膜分离的TF巩膜内囊袋手术是一种在易发生青光眼的玻璃体切除术后眼中进行睫状沟固定的成功方法。