Oh S Y, Lee S J, Park J M
Department of Ophthalmology, Maryknoll Hospital, Busan, South Korea.
Department of Ophthalmology, Haeundae Paek Hospital, Busan, South Korea.
Eye (Lond). 2015 Jun;29(6):757-63. doi: 10.1038/eye.2015.22. Epub 2015 Mar 20.
The purpose of this study was to compare the surgical outcomes of intraocular lens (IOL) refixation with intraocular lens exchange using perfluorocarbon liquid (PFCL) and fibrin glue-assisted sutureless scleral fixation surgery in patients with dislocation of the IOL.
Twenty-five eyes of 25 patients who underwent surgery for dislocated IOLs with PFCL and fibrin glue-assisted scleral fixation were studied; 13 eyes experienced IOL refixation (in-the-bag and out-of-the-bag), and 12 eyes experienced IOL exchange. Preoperative and postoperative clinical features from patient charts and 25 eyes with >6 months' follow-up information were reviewed and analyzed.
At postoperative 6 months, best-corrected visual acuity (BCVA) and spherical equivalent of IOL refixation and exchange were significantly improved (P=0.042, P=0.001), and endothelial cell density was significantly decreased in the two groups with no significant difference between them. Surgically induced astigmatism of IOL refixation improved from 0.90±0.47 to 0.61±0.37 (P=0.012), and IOL exchange improved from 1.17±0.64 to 0.73±0.37 (P=0.037) at postoperative 6 months, with no significant difference between the two groups. Complications occurred in four eyes in the IOL refixation group and in three eyes in the IOL exchange group.
PFCL and fibrin glue-assisted IOL sutureless scleral refixation or exchanged fixation was an effective surgical treatment for IOL dislocation. Also, because postoperative BCVA, surgical outcomes, and complications did not differ significantly between IOL refixation and exchange surgery, if IOL exchange surgery is not indicated, IOL refixation surgical techniques should be considered.
本研究旨在比较使用全氟碳液体(PFCL)和纤维蛋白胶辅助无缝线巩膜固定手术进行人工晶状体(IOL)复位与人工晶状体置换在人工晶状体脱位患者中的手术效果。
对25例行PFCL和纤维蛋白胶辅助巩膜固定治疗人工晶状体脱位手术的25例患者的25只眼进行研究;13只眼进行了人工晶状体复位(囊内和囊外),12只眼进行了人工晶状体置换。回顾并分析了患者病历中的术前和术后临床特征以及25只随访时间超过6个月的眼的信息。
术后6个月时,人工晶状体复位组和置换组的最佳矫正视力(BCVA)和人工晶状体球镜等效度数均显著提高(P = 0.042,P = 0.001),两组的内皮细胞密度均显著降低,但两组之间无显著差异。人工晶状体复位组的手术诱导散光在术后6个月时从0.90±0.47改善至0.61±0.37(P = 0.012),人工晶状体置换组从1.17±0.64改善至0.73±0.37(P = 0.037),两组之间无显著差异。人工晶状体复位组有4只眼发生并发症,人工晶状体置换组有3只眼发生并发症。
PFCL和纤维蛋白胶辅助的人工晶状体无缝线巩膜复位或置换固定是治疗人工晶状体脱位的有效手术方法。此外,由于人工晶状体复位和置换手术在术后BCVA、手术效果和并发症方面无显著差异,若未指明进行人工晶状体置换手术,则应考虑人工晶状体复位手术技术。