Department of Ophthalmology, Mahatma Gandhi Memorial Medical College, M.Y. Hospital, Indore, Madhya Pradesh, India.
Indian J Ophthalmol. 2019 Jan;67(1):64-68. doi: 10.4103/ijo.IJO_447_18.
To report results of a novel technique for sutureless, glueless intrascleral fixation of three-piece posterior chamber intraocular lens (IOL) using 26-G needle for management of aphakia.
In this prospective series, 30 eyes of 20 patients with aphakia, subluxated IOL, or crystalline lens were included. 26-G-needle-guided intrascleral fixation of three-piece posterior chamber IOL was performed according to the described technique. The patients were evaluated on day 2, 1 week, 6 weeks, and 3 months postoperatively for change in best-corrected visual acuity (BCVA), intraocular pressure (IOP), IOL centration, and any other complications. The postoperative tilt of the IOL was indirectly measured by determining the lenticular astigmatism which in turn was calculated by the difference between net corneal astigmatism and refractive astigmatism. Paired t-test was used to determine the significance of any association between the preoperative and postoperative BCVA and IOP. P < 0.05 was considered significant.
Of 30 eyes (n = 30 patients), 18 were surgical aphakia, 6 traumatic aphakia, 5 subluxated IOL, and 1 ectopia lentis (Marfan syndrome). The mean preoperative BCVA was 1.37 ± 0.37 (logMAR) and postoperative BCVA at 3 months was 0.37 ± 0.29 (logMAR). A significant improvement in the mean BCVA (P < 0.05) was observed after the procedure. The mean IOP preoperatively was 13.33 ± 4.18 and postoperatively at 3 months was 12.82 ± 3.97 (P > 0.05), which was not significant. None of the eyes developed any intraoperative and postoperative complications. The IOLs had appropriate centration and stability.
We have developed this new technique for intrascleral IOL fixation which is quite simple, cost-effective, minimally invasive, neither requires glue nor suture and gives consistent outcome.
报告一种使用 26-G 针头进行无缝线、无胶的三房后房型人工晶状体(IOL)经巩膜内固定术的新型技术的结果,用于治疗无晶状体、IOL 半脱位或晶状体脱位。
在这项前瞻性系列研究中,纳入了 20 名患者的 30 只眼,这些患者均患有无晶状体、IOL 半脱位或晶状体脱位。根据所描述的技术,使用 26-G 针头引导三房后房型人工晶状体经巩膜内固定。术后第 2、1 周、6 周和 3 个月对患者进行最佳矫正视力(BCVA)、眼压(IOP)、IOL 中心位置和任何其他并发症的评估。通过确定净角膜散光和屈光性散光之间的差异来间接测量 IOL 的术后倾斜度,从而计算出晶状体散光。使用配对 t 检验来确定术前和术后 BCVA 和 IOP 之间的任何关联的显著性。P < 0.05 被认为具有统计学意义。
30 只眼中(n = 30 例),18 只为手术性无晶状体,6 只为外伤性无晶状体,5 只为 IOL 半脱位,1 只为晶状体异位(马凡综合征)。平均术前 BCVA 为 1.37 ± 0.37(logMAR),术后 3 个月时为 0.37 ± 0.29(logMAR)。术后平均 BCVA 显著提高(P < 0.05)。术前平均眼压为 13.33 ± 4.18mmHg,术后 3 个月时为 12.82 ± 3.97mmHg(P > 0.05),差异无统计学意义。所有患者均未发生任何术中及术后并发症。IOL 位置适当且稳定。
我们开发了这种新型的经巩膜 IOL 固定技术,该技术非常简单、经济有效、微创,既不需要胶水也不需要缝线,并且结果一致。