Kaluzny Bartlomiej J, Laudencka Adriana, Malukiewicz Grazyna
Department of Ophthalmology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz - Poland.
Eur J Ophthalmol. 2015 May-Jun;25(3):254-7. doi: 10.5301/ejo.5000538. Epub 2014 Nov 19.
To present a modified surgical technique for scleral suture fixation of a new foldable intraocular lens (IOL) design with fenestrations in the proximal part of the haptics.
An experimental model of a double continuous-loop 4-point scleral suture fixation of IOL with fenestrations in the proximal part of the haptics showed that with conventional techniques, the lens is located in a horizontal plane 90° to the expected iris plane. To achieve proper IOL positioning, we modified the technique so as to perform 2 needle passes through the sclera for each haptic in the same meridian, resulting in the external part of the suture being radial to the limbus. The technique was performed in 14 eyes. Mean follow-up time was 9.8 months.
In all cases, the lens was successfully implanted through clear corneal tunnel incision and the scleral fixation, as mentioned above, was performed with the use of Hoffman scleral pockets. Good centration of the IOLs without signs of tilt was achieved.
It is possible to decrease the risk of tilt of the IOL with fenestrations in the proximal part of the haptics by modifying the technique so that the 2 needle passes through the sclera for each haptic are done in the same meridian, resulting in a layout of the external part of the suture being radial to the limbus.
介绍一种改良的手术技术，用于对一种新型可折叠人工晶状体（IOL）进行巩膜缝线固定，该人工晶状体在襻的近端有开窗设计。
对一种在襻近端有开窗的人工晶状体进行双连续环四点巩膜缝线固定的实验模型表明，采用传统技术时，晶状体位于与预期虹膜平面成90°的水平面内。为实现人工晶状体的正确定位，我们对技术进行了改良，使每个襻在同一子午线上穿过巩膜两次，从而使缝线的外部部分呈放射状朝向角膜缘。该技术应用于14只眼。平均随访时间为9.8个月。
在所有病例中，晶状体均通过透明角膜隧道切口成功植入，并如上述使用霍夫曼巩膜袋进行巩膜固定。人工晶状体实现了良好的居中，无倾斜迹象。
通过改良技术，使每个襻穿过巩膜两次在同一子午线上进行，从而使缝线的外部部分呈放射状朝向角膜缘，可以降低襻近端有开窗的人工晶状体发生倾斜的风险。
