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使用戈尔特斯缝线进行人工晶状体巩膜固定术:临床结果和安全性概况。

Scleral fixation of intraocular lenses using Gore-Tex suture: clinical outcomes and safety profile.

作者信息

Khan M Ali, Gupta Omesh P, Smith Ryan G, Ayres Brandon D, Raber Irving M, Bailey Robert S, Hsu Jason, Spirn Marc J

机构信息

Retina Service Wills Eye Hospital, Philadelphia, Pennsylvania, USA.

Cornea Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA.

出版信息

Br J Ophthalmol. 2016 May;100(5):638-43. doi: 10.1136/bjophthalmol-2015-306839. Epub 2015 Aug 28.

Abstract

BACKGROUND/AIMS: To report the short-term safety profile and clinical outcomes of scleral fixation of intraocular lenses (IOLs) using Gore-Tex suture.

METHODS

Retrospective, interventional case series. 85 eyes of 84 patients undergoing ab externo scleral fixation of a Bausch and Lomb Akreos AO60 or Alcon CZ70BD IOL using Gore-Tex suture. Primary outcome measures were change in visual acuity and occurrence of intraoperative and postoperative complications with minimum follow-up of 90 days.

RESULTS

85 eyes of 84 patients were identified. Mean logarithm of the minimum angle of resolution visual acuity improved from 1.43±0.72 (20/538 Snellen equivalent) preoperatively to 0.64±0.61 (20/87 Snellen equivalent) postoperatively (p<0.001). Mean follow-up was 325 days (median 264 days, range 90-996 days). There were no intraoperative complications noted. Postoperative complications included hypotony in eight patients (9.4%), ocular hypertension in six eyes (7%), vitreous haemorrhage in six eyes (7%), hyphema in two eyes (2%), serous choroidal detachment in two eyes (2%), cystoid macular oedema in two eyes (2%) and corneal oedema in one eye (1%). There were no cases of postoperative endophthalmitis, suture erosion/breakage, retinal detachment, suprachoroidal haemorrhage, uveitis-glaucoma-hyphema syndrome or persistent postoperative inflammation in the follow-up period.

CONCLUSIONS

Ab externo scleral fixation of IOLs with Gore-Tex suture was well tolerated in all cases. No suture-related complications were encountered. This procedure led to improvement in visual acuity and was not associated with significant intraoperative or postoperative complications.

摘要

背景/目的:报告使用戈尔特斯缝线进行人工晶状体(IOL)巩膜固定术的短期安全性和临床结果。

方法

回顾性、介入性病例系列研究。84例患者的85只眼接受了使用戈尔特斯缝线经外路巩膜固定博士伦Akreos AO60或爱尔康CZ70BD人工晶状体手术。主要观察指标为视力变化以及术中及术后并发症的发生情况,最短随访时间为90天。

结果

确定了84例患者的85只眼。最小分辨角视力的平均对数术前为1.43±0.72(相当于Snellen视力表的20/538),术后提高到0.64±0.61(相当于Snellen视力表的20/87)(p<0.001)。平均随访时间为325天(中位数264天,范围90 - 996天)。术中未发现并发症。术后并发症包括8例患者发生低眼压(9.4%)、6只眼发生高眼压(7%)、6只眼发生玻璃体积血(7%)、2只眼发生前房积血(2%)、2只眼发生浆液性脉络膜脱离(2%)、2只眼发生黄斑囊样水肿(2%)和1只眼发生角膜水肿(1%)。随访期间未发生术后眼内炎、缝线侵蚀/断裂、视网膜脱离、脉络膜上腔出血、葡萄膜炎-青光眼-前房积血综合征或持续性术后炎症病例。

结论

所有病例中,经外路使用戈尔特斯缝线进行人工晶状体巩膜固定术耐受性良好。未遇到与缝线相关的并发症。该手术可提高视力,且未伴有明显的术中或术后并发症。

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