From the Centre for Ophthalmology (S. Dimopoulos, Trevino-Rodriguez, Bartz-Schmidt, Spitzer, Voykov), University Hospital Tübingen, and the Institute for Clinical Epidemiology and Applied Biometry (Blumenstock), Eberhard Karls University of Tübingen, Tübingen, and the Department of Ophthalmology (V. Dimopoulos, Spitzer), University Medical Center, Hamburg-Eppendorf, Germany.
From the Centre for Ophthalmology (S. Dimopoulos, Trevino-Rodriguez, Bartz-Schmidt, Spitzer, Voykov), University Hospital Tübingen, and the Institute for Clinical Epidemiology and Applied Biometry (Blumenstock), Eberhard Karls University of Tübingen, Tübingen, and the Department of Ophthalmology (V. Dimopoulos, Spitzer), University Medical Center, Hamburg-Eppendorf, Germany.
J Cataract Refract Surg. 2018 Feb;44(2):182-185. doi: 10.1016/j.jcrs.2017.11.009. Epub 2018 Mar 2.
To assess the long-term results and complications of scleral-fixated posterior chamber intraocular lenses (PC IOLs) with the knotless Z-suture technique.
University Eye Hospital, Tübingen, Germany.
Retrospective case series.
Records of consecutive patients who had implantation of scleral-fixated PC IOLs with the knotless Z-suture technique with a minimum follow-up of 3 years were reviewed.
Sixty-six eyes of 62 patients were included. The mean preoperative corrected distance visual acuity (CDVA) was 0.71 logarithm of the minimum angle of resolution (logMAR) ± 0.58 (SD). The mean CDVA was 0.67 ± 0.54 logMAR (P = .257; n = 66) after 3 years, 0.73 ± 0.55 logMAR (P = .399; n = 60) after 5 years, 0.8 ± 0.68 logMAR (P = .348; n = 30) after 8 years, and 1.09 ± 0.76 logMAR (P = .069; n = 13) after 10 years. Failure because of suture breakage was observed in 11 eyes (16.7%) after a mean of 7.5 years. Kaplan-Meier time-to-event analysis showed a 40% failure probability after 10 years. Traumatic aphakia was the only risk factor for failure (odds ratio 4.1; 95% confidence interval, 1.0-18.3; P = .049). Complications included retinal detachment (15%), cystoid macular edema (9%), increased intraocular pressure requiring surgical intervention (7.6%), corneal edema (4.5%), and posterior iris-chafing syndrome with microhyphema (3%).
Implantation of scleral-fixated PC IOLs using the knotless Z-suture was a safe technique resulting in good visual outcomes. The long-term success of the procedure was dependent on the material properties of the suture.
评估无结 Z 缝线技术行巩膜固定后房型人工晶状体（PC IOL）的长期结果和并发症。
德国图宾根大学眼科医院。
回顾性病例系列。
回顾连续接受无结 Z 缝线技术行巩膜固定 PC IOL 植入术且随访时间至少 3 年的患者记录。
纳入 62 例 66 只眼。术前平均矫正远视力（CDVA）为 0.71 对数最小角分辨率（logMAR）±0.58（SD）。术后 3 年，平均 CDVA 为 0.67±0.54 logMAR（P=0.257；n=66），5 年时为 0.73±0.55 logMAR（P=0.399；n=60），8 年时为 0.8±0.68 logMAR（P=0.348；n=30），10 年时为 1.09±0.76 logMAR（P=0.069；n=13）。11 只眼（16.7%）在平均 7.5 年后因缝线断裂而失败。Kaplan-Meier 生存分析显示，10 年后失败的概率为 40%。创伤性无晶状体是失败的唯一危险因素（比值比 4.1；95%置信区间，1.0-18.3；P=0.049）。并发症包括视网膜脱离（15%）、囊样黄斑水肿（9%）、需要手术干预的眼压升高（7.6%）、角膜水肿（4.5%）和后发性虹膜擦伤伴微前房积血（3%）。
无结 Z 缝线技术行巩膜固定 PC IOL 是一种安全的技术，可获得良好的视力结果。手术的长期效果取决于缝线的材料特性。
