Teng He, Zhang Hong
Tianjin Medical University Eye Center, Fukang Road 251, Nankai District, Tianjin 300384, China.
Int J Ophthalmol. 2014 Apr 18;7(2):283-7. doi: 10.3980/j.issn.2222-3959.2014.02.16. eCollection 2014.
To compare the efficacy and complications of Artisan iris-claw intraocular lens (IOL) implantation and posterior chamber IOL sulcus fixation for the treatment of aphakic eyes without capsular support after vitrectomy.
A prospective study of 45 cases was conducted. Forty-five eyes without sufficient lens capsule support following pars plana vitrectomy (PPV) combined lens extraction were divided into two groups. Group A: 25 eyes received Artisan iris-claw IOL implantation. Group B: 20 eyes received posterior chamber IOL sulcus fixation. The corrected distance visual acuity (CDVA) and intraocular pressure (IOP), corneal endothelial cell loss rate, surgical time and complications were compared between the two groups. Pigment changes of trabecular meshwork and anterior chamber depths were measured at each time point in Artisan group.
The mean surgical time of Artisan group was significantly shorter (P<0.05). No statistically significant difference in endothelial cell loss rate was noted between two groups at any time point (P>0.05). CDVA of Artian group was better than that of the sulcus fixation group 1d after surgery (P<0.05) and there was no statistically significant difference 1 and 3mo after surgery (P>0.05). Mean IOP showed no significant differences between groups before and after surgery. The postoperative complications of Artisan group were anterior uveitis, iris depigmentation, pupillary distortion and spontaneous lens dislocation. The complications of sulcus fixation group include choroidal detachment, intraocular haemorrhage, tilt of IOL optic part and retinal detachment.
Secondary Artisan IOL implantation can be performed less invasively and in a shorter surgical time period with earlier visual recovery after surgery compared to transscleral suturing fixation of an IOL. This technique is an effective and safe procedure. It is a promising option for the treatment of aphakic eyes without capsular support after vitrectomy.
比较Artisan虹膜爪型人工晶状体（IOL）植入术与后房型IOL睫状沟固定术治疗玻璃体切除术后无晶状体囊支持的无晶状体眼的疗效及并发症。
进行一项前瞻性研究，纳入45例患者。45只在经平坦部玻璃体切除术（PPV）联合晶状体摘除术后无足够晶状体囊支持的眼被分为两组。A组：25只眼接受Artisan虹膜爪型IOL植入术。B组：20只眼接受后房型IOL睫状沟固定术。比较两组的矫正远视力（CDVA）、眼压（IOP）、角膜内皮细胞丢失率、手术时间及并发症。在Artisan组的每个时间点测量小梁网色素变化及前房深度。
Artisan组的平均手术时间明显更短（P<0.05）。两组在任何时间点的内皮细胞丢失率均无统计学显著差异（P>0.05）。Artisan组术后1天的CDVA优于睫状沟固定组（P<0.05），术后1个月和3个月无统计学显著差异（P>0.05）。两组术前和术后的平均IOP无显著差异。Artisan组的术后并发症包括前葡萄膜炎、虹膜色素脱失、瞳孔变形和晶状体自发脱位。睫状沟固定组的并发症包括脉络膜脱离、眼内出血、IOL光学部倾斜和视网膜脱离。
与IOL经巩膜缝合固定术相比，二期Artisan IOL植入术具有更小的侵袭性，手术时间更短，术后视力恢复更早。该技术是一种有效且安全的手术方法。它是治疗玻璃体切除术后无晶状体囊支持的无晶状体眼的一个有前景的选择。
