Kujime Yuki, Akimoto Masayuki
Osaka Red Cross Hospital, 5-30 Fudegasakicho, Tennojiku, Osaka, 543-8555, Japan.
Int Ophthalmol. 2019 May;39(5):1163-1168. doi: 10.1007/s10792-018-0911-5. Epub 2018 Mar 28.
We evaluated a new concept for treating pupillary capture of the intraocular lens (IOL) following intrascleral fixation of the IOL. Pupillary capture of the IOL is a common postoperative complication that occurs after suturing and intrascleral fixation of the IOL. In such cases, blunt trauma is often related to zonular dialysis, iris retraction, iridodonesis, and angle recession. Several methods such as barricading by suturing, pupilloplasty, and pars plana fixation are reported to prevent pupillary capture. Although effective, none of these techniques fix iris-malposition and angle recession. We considered that repairing angle recession could correct the iris position and prevent pupillary capture recurrence.
We repaired angle recession in four cases and have followed up.
Pupillary capture was not observed in all three cases of larger IOLs for more than 9 months, but observed after 1 month in an IOL with normal 6 mm diameter, in which the angle was not properly lifted.
In select cases, repairing angle recession may be useful for preventing pupillary capture after IOL suturing and intrascleral fixation.
我们评估了一种治疗人工晶状体(IOL)巩膜内固定术后瞳孔捕获人工晶状体的新概念。人工晶状体的瞳孔捕获是IOL缝合和巩膜内固定术后常见的术后并发症。在这种情况下,钝性创伤常与悬韧带断裂、虹膜后缩、虹膜震颤和房角后退有关。据报道,有几种方法如缝合阻挡、瞳孔成形术和平坦部固定可预防瞳孔捕获。尽管这些技术有效,但均未修复虹膜位置异常和房角后退。我们认为修复房角后退可以纠正虹膜位置并防止瞳孔捕获复发。
我们对4例患者进行了房角后退修复并进行了随访。
3例较大人工晶状体患者在9个月以上均未观察到瞳孔捕获,但1例直径正常为6mm的人工晶状体在1个月后观察到瞳孔捕获,其房角未得到适当提升。
在某些情况下,修复房角后退可能有助于预防IOL缝合和巩膜内固定术后的瞳孔捕获。