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虹膜夹型人工晶状体植入术:根据技术的有效性和安全性。

Iris-claw intraocular lens implantation: Efficiency and safety according to technique.

机构信息

From the Ophthalmology Department (Hernández Martínez), Oftalvist Clinic, the Ophthalmology Department (Hernández Martínez), and the Department of Statistics and Research Methodology (Almeida González), Valme University Hospital, Seville, Spain.

From the Ophthalmology Department (Hernández Martínez), Oftalvist Clinic, the Ophthalmology Department (Hernández Martínez), and the Department of Statistics and Research Methodology (Almeida González), Valme University Hospital, Seville, Spain.

出版信息

J Cataract Refract Surg. 2018 Oct;44(10):1186-1191. doi: 10.1016/j.jcrs.2018.06.049. Epub 2018 Aug 16.

DOI:10.1016/j.jcrs.2018.06.049
PMID:30122352
Abstract

PURPOSE

To evaluate the safety, refractive and visual results of an iris-claw intraocular lens for aphakia (Artisan) according to the technique used.

SETTING

Ophthalmology Department, Valme University Hospital and Oftalvist Clinic, Seville, Spain.

DESIGN

Retrospective case series.

METHODS

This study evaluated the outcomes of iris-claw IOL implantations performed by the same surgeon between 2011 and 2017. The results were analyzed by the incision type (corneal versus scleral tunnel) and lens position (prepupillary versus retropupillary).

RESULTS

Seventy-six eyes (75 patients) were included. The postoperative uncorrected (UDVA) and corrected (CDVA) distance visual acuities were significantly better than the preoperative acuities (P < .001). The UDVA was 20/40 or better in 41.7% of patients, and had the CDVA was 20/40 or better in 68.1% of patients. The mean UDVA was significantly better in the scleral tunnel incision group (0.29 logarithm of the minimum angle of resolution [logMAR] ± 0.41 [SD]) than in the corneal incision group (0.66 ± 0.45 logMAR) (P < .001). The mean surgically induced astigmatism in the scleral tunnel incision group (0.73 ± 0.62 diopter [D]) was significantly lower than in the corneal incision group (2.49 ± 1.36 D) (P < .001). Although endothelial cell loss was lower in the retropupillary position, the difference was not significant (P = .07.) CONCLUSION: Implantation of the iris-claw IOL in the retropupillary position and through a scleral tunnel incision was an effective and safe alternative to aphakia without capsule support, providing better refractive results compared with other techniques.

摘要

目的

根据所使用的技术,评估无晶状体眼(Artisan)虹膜夹型人工晶状体的安全性、屈光和视觉效果。

地点

西班牙塞维利亚瓦尔梅大学医院和 Oftalvist 诊所眼科。

设计

回顾性病例系列。

方法

本研究评估了 2011 年至 2017 年间由同一位外科医生进行的虹膜夹式人工晶状体植入术的结果。通过切口类型(角膜与巩膜隧道)和晶状体位置(前房与后房)对结果进行分析。

结果

76 只眼(75 例患者)纳入研究。术后未矫正(UDVA)和矫正(CDVA)远视力明显优于术前(P<0.001)。41.7%的患者术后 UDVA 达到 20/40 或更好,68.1%的患者术后 CDVA 达到 20/40 或更好。巩膜隧道切口组的平均 UDVA(0.29 对数最小角分辨率 [logMAR]±0.41 [SD])明显优于角膜切口组(0.66±0.45 logMAR)(P<0.001)。巩膜隧道切口组的平均手术诱导散光(0.73±0.62 屈光度 [D])明显低于角膜切口组(2.49±1.36 D)(P<0.001)。虽然后房型的内皮细胞丢失较低,但差异无统计学意义(P=0.07)。

结论

对于无晶状体囊支持的无晶状体眼,植入后房型虹膜夹型人工晶状体并通过巩膜隧道切口是一种有效且安全的替代方法,与其他技术相比,提供更好的屈光效果。

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