Cornea Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
School of Public Health, Department of Biostatistics, Johns Hopkins University, Baltimore, Maryland.
Am J Ophthalmol. 2015 Feb;159(2):353-9. doi: 10.1016/j.ajo.2014.11.009. Epub 2014 Nov 7.
To assess the results of iris suture fixation of subluxated intraocular lenses.
Retrospective study.
This was a nonrandomized chart review of eyes with subluxated intraocular lenses that underwent iris suture fixation at an academic institutional care center. Seventy-two eyes of 67 consecutive patients were included. The following cases were excluded: posterior dislocations necessitating pars plana vitrectomy; secondary implantations for aphakia; and iris suture fixation at primary cataract extraction. Main outcome measures included visual acuity improvement, surgically induced astigmatism, and postsurgical complications.
The mean follow-up duration was 16.64 ± 24.37 months (median = 4.03 months). All patients had preoperative monocular diplopia or unstable vision attributable to the subluxated intraocular lenses, and 40.3% of them required aphakic correction. There was an overall improvement in best-corrected visual acuity from a mean preoperative logMAR 0.35 ± 0.32 (Snellen equivalent∼20/45) to logMAR 0.21 ± 0.25 (20/32, P = .001). There was no significant change in astigmatism secondary to the surgery. The mean difference in preoperative keratometry readings was 1.6 ± 1.07 diopter (D), whereas the mean postoperative manifest refraction astigmatic error (vertexed to the corneal surface) was 1.29 ± 0.92 D (P < .02). Re-subluxations occurred in 7 eyes during follow-up; the majority of these eyes underwent repeat fixation. Most (93.55%) intraocular lenses were stable and centered at the final follow-up. Glaucoma developed in 2 eyes postoperatively.
Iris suture fixation of subluxated intraocular lenses was efficacious for the eyes included in this study, and it led to long-term stability of the intraocular lenses in 93.55% of cases.
评估虹膜缝线固定半脱位人工晶状体的效果。
回顾性研究。
这是对在学术机构护理中心接受虹膜缝线固定术的半脱位人工晶状体眼进行的非随机图表回顾。纳入了 67 例连续患者的 72 只眼。排除以下病例：需要行睫状体平坦部玻璃体切除术的后脱位；无晶状体眼的二次植入；以及在初次白内障摘除时进行虹膜缝线固定。主要观察指标包括视力提高、手术引起的散光和术后并发症。
平均随访时间为 16.64±24.37 个月（中位数=4.03 个月）。所有患者术前均有单眼复视或因半脱位人工晶状体导致的不稳定视力，其中 40.3%的患者需要无晶状体矫正。最佳矫正视力总体上有所提高，从术前平均 logMAR0.35±0.32（Snellen 等效视力约为 20/45）提高到 logMAR0.21±0.25（20/32，P=0.001）。手术引起的散光无明显变化。术前角膜曲率读数的平均差异为 1.6±1.07 屈光度（D），而术后平均角膜散光（角膜顶点测量）为 1.29±0.92 D（P<0.02）。7 只眼在随访期间再次半脱位；这些眼中的大多数都进行了重复固定。在最终随访时，大多数（93.55%）人工晶状体稳定且居中。2 只眼术后发生青光眼。
对于本研究纳入的眼睛，虹膜缝线固定半脱位人工晶状体是有效的，并且 93.55%的病例中人工晶状体长期稳定。
