Elhofi Abdelhamid, Helaly Hany Ahmed, Said Amr
Ophthalmology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
J Ophthalmol. 2019 Feb 14;2019:1356982. doi: 10.1155/2019/1356982. eCollection 2019.
To compare the refractive outcome of 2 different methods of intraocular lens implantation in cases of posterior microphthalmos, primary piggyback IOLs versus secondary iris claw lenses.
This study was a retrospective interventional comparative study that included 60 eyes of 30 patients. The included patients had bilateral microphthalmos with high axial hyperopia and had undergone a lens-based surgical procedure for hyperopia correction. The included patients were equally divided into two groups. The first group had undergone refractive lens exchange (RLE) with primary piggyback IOL implantation. The second group undergone RLE with maximum available IOL power implanted followed by a secondary implantation of Artisan iris-fixated IOL (Ophtec B.V., Groningen, the Netherlands).
The 2 groups were highly comparable to each other regarding the mean age, axial length (AL), manifest refraction (MR), and readings. Postoperatively, there was a statistically significant difference between the 2 groups regarding the manifest refraction spherical equivalent (MRSE), mean absolute error (MAE), and uncorrected distance visual acuity (UDVA). There was no significant difference between the 2 groups regarding the CDVA. At 36 months, 20% and 73% of the eyes were within ±0.5 D of intended refraction at 36 months in 1ry piggyback and 2ry Artisan groups, respectively. Fifty-three percent and 93% of the eyes were within ±1.0 D of intended refraction at 36 months in 1ry piggyback and 2ry Artisan groups, respectively (=0.001).
Secondary procedure with implantation of iris-fixated intraocular lens yielded very good results for treatment of axial hyperopia in cases of posterior microphthalmos. The primary piggyback IOL showed less satisfactory results with cases of under correction and the possible complication of interlenticular opacification. Both groups showed good safety parameters.
比较在小眼球后段病例中两种不同人工晶状体植入方法（一期背负式人工晶状体与二期虹膜爪形晶状体）的屈光结果。
本研究为回顾性干预性比较研究，纳入30例患者的60只眼。纳入的患者均为双侧小眼球伴高度轴性远视，且接受了基于晶状体的远视矫正手术。纳入的患者平均分为两组。第一组接受了一期背负式人工晶状体植入的屈光性晶状体置换术（RLE）。第二组接受了植入最大可用人工晶状体度数的RLE，随后二期植入Artisan虹膜固定型人工晶状体（荷兰格罗宁根Ophtec B.V.公司）。
两组在平均年龄、眼轴长度（AL）、显验光（MR）和读数方面具有高度可比性。术后，两组在显验光球镜等效值（MRSE）、平均绝对误差（MAE）和未矫正远视力（UDVA）方面存在统计学显著差异。两组在矫正视力（CDVA）方面无显著差异。在36个月时，一期背负式人工晶状体组和二期Artisan人工晶状体组分别有20%和73%的眼在预期屈光度±0.5D范围内。一期背负式人工晶状体组和二期Artisan人工晶状体组分别有53%和93%的眼在36个月时在预期屈光度±1.0D范围内（P = 0.001）。
二期植入虹膜固定型人工晶状体治疗小眼球后段轴性远视效果非常好。一期背负式人工晶状体在欠矫病例中效果不太理想，且存在晶状体间浑浊的可能并发症。两组均显示出良好的安全性参数。
