Bieliński Paweł, Jasielska Monika, Wyszyńska Anna, Winiarczyk Mateusz, Mackiewicz Jerzy
Department of Vitreoretinal Surgery, Medical University of Lublin, ul. Chmielna 1, 20-079, Lublin, Poland.
Int Ophthalmol. 2019 Feb;39(2):455-460. doi: 10.1007/s10792-017-0812-z. Epub 2018 Jan 11.
To present our experience with post-traumatic lens dislocation management by vitrectomy followed with sutureless artificial lens fixation.
The retrospective study involved 15 patients (12 men and 3 women) aged from 36 to 78 (on average, 63 years old), from the Vitreoretinal Surgery Teaching Hospital, operated in the years 2013-2015. All cases concerned ocular traumas with dislocation of the natural or artificial lens to the anterior chamber, vitreous body chamber, or post-traumatic aphakia. After vitrectomy, patients had the implant fixated with a technique devised by Scharioth-sutureless fixation of posterior chamber implants in the groove area, with haptics placed in scleral tunnels parallel to the corneal limbus. Preoperative and postoperative condition of the eye was assessed.
The average period of observation was 29 weeks. Average pre-surgery refraction was + 10.75, while post-surgery + 1.25. Average best-corrected visual acuity in Snellen charts before surgery was 0.3 and at the end of the observation period 0.5. The improvement in visual acuity after surgery in relation to visual acuity before surgery was statistically significant (P = 0.005). In the first 2 weeks after surgery, minor hypotonia was observed in three of the patients, while in two-moderate bleeding to the vitreous body and the anterior chamber, which subsided without surgical intervention. A slight decentration of the implant observed in two cases did not affect later refraction or BCVA.
Basing on the abovementioned facts, we believe that this surgical approach facilitates the fixation of the dislocated lens and allows a successful treatment of secondary implantation or repositioning of a dislocated intraocular lens.
介绍我们通过玻璃体切除术联合无缝线人工晶状体固定术治疗创伤性晶状体脱位的经验。
这项回顾性研究纳入了2013年至2015年间在玻璃体视网膜手术教学医院接受手术的15例患者（12例男性和3例女性），年龄在36至78岁之间（平均63岁）。所有病例均为眼外伤，天然晶状体或人工晶状体脱位至前房、玻璃体腔或创伤后无晶状体眼。玻璃体切除术后，采用Scharioth设计的技术固定植入物——后房型植入物在沟区的无缝线固定，襻置于平行于角膜缘的巩膜隧道内。评估术前和术后患眼的情况。
平均观察期为29周。术前平均屈光度数为+10.75，术后为+1.25。术前Snellen视力表的平均最佳矫正视力为0.3，观察期末为0.5。术后视力相对于术前视力的改善具有统计学意义（P = 0.005）。术后前2周，3例患者出现轻度低眼压，2例患者出现玻璃体腔和前房中度出血，未经手术干预出血自行消退。2例患者观察到植入物轻微偏心，但未影响后期屈光或最佳矫正视力。
基于上述事实，我们认为这种手术方法有助于脱位晶状体的固定，并能成功治疗脱位人工晶状体的二期植入或复位。
