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眼外伤患者无结膜切开及巩膜切开的巩膜固定人工晶状体植入术的长期预后

Long-term outcome of scleral-fixated intraocular lens implantation without conjunctival peritomies and sclerotomy in ocular trauma patients.

作者信息

Zhao Han, Wang Wanpeng, Hu Zhengping, Chen Baihua

机构信息

Department of Ophthalmology, Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China.

Hunan Clinical Research Center of Ophthalmic Disease, Changsha, Hunan Province, China.

出版信息

BMC Ophthalmol. 2019 Jul 29;19(1):164. doi: 10.1186/s12886-019-1172-4.

Abstract

BACKGROUND

To investigate the long-term outcomes and complications of scleral-fixated intraocular lens (SFIOL) implantation without conjunctival peritomies and sclerotomy in patients with a history of ocular trauma with inadequate capsular support during primary pars plana vitrectomy or silicone oil removal.

METHODS

Records of ocular trauma patients who underwent implantation of SFIOL without conjunctival peritomies and sclerotomy during primary pars plana vitrectomy or silicone oil removal.

RESULTS

Sixty-nine eyes of 69 patients were included in this study. The median follow-up period was 34 months (range, 6-99 months). The average patient age at the time of surgery was 44 years old (range, 4-80 years). At the end of follow-up, the preoperative mean of best corrected visual acuity (BCVA) was 0.79 ± 0.86 log of the minimum angle of resolution (logMAR), which improved 0.20 ± 0.26 logMAR postoperatively (P = 0.01). BCVA improved or remained unchanged in 64 eyes (92.8%), VA decreased two lines in five eyes (7.2%). Early postoperative complications included transient corneal edema in seven eyes (10.1%), minor vitreous hemorrhage in four eyes (5.8%), transient elevated intraocular pressure (IOP) in one eye (1.4%), and hypotony in three eyes (4.3%). Late postoperative complications included persistent elevated IOP in five eyes (7.2%), epiretinal membrane formation in three eyes (4.3%), and cystoid macular edema noted in one eye (1.4%).

CONCLUSIONS

Use of a scleral-fixated intraocular lens implantation without conjunctival peritomies and sclerotomy in ocular trauma patients during either primary pars plana vitrectomy or second silicone oil removal is a valuable approach for the management of traumatic aphakia in the absence of capsular support.

摘要

背景

探讨在原发性玻璃体切割术或硅油取出术中因眼外伤导致囊袋支撑不足的患者,行无结膜切开和巩膜切开的巩膜固定人工晶状体(SFIOL)植入术的长期疗效和并发症。

方法

记录在原发性玻璃体切割术或硅油取出术中接受无结膜切开和巩膜切开的SFIOL植入术的眼外伤患者的情况。

结果

本研究纳入了69例患者的69只眼。中位随访期为34个月(范围6 - 99个月)。手术时患者的平均年龄为44岁(范围4 - 80岁)。随访结束时,术前最佳矫正视力(BCVA)的平均值为0.79±0.86最小分辨角对数(logMAR),术后提高了0.20±0.26 logMAR(P = 0.01)。64只眼(92.8%)的BCVA提高或保持不变,5只眼(7.2%)的视力下降了两行。术后早期并发症包括7只眼(10.1%)出现短暂性角膜水肿、4只眼(5.8%)出现少量玻璃体积血、1只眼(1.4%)出现短暂性眼压(IOP)升高、3只眼(4.3%)出现低眼压。术后晚期并发症包括5只眼(7.2%)出现持续性IOP升高、3只眼(4.3%)出现视网膜前膜形成、1只眼(1.4%)出现黄斑囊样水肿。

结论

在原发性玻璃体切割术或二次硅油取出术中,对眼外伤患者行无结膜切开和巩膜切开的巩膜固定人工晶状体植入术,是治疗无囊袋支撑的外伤性无晶状体眼的一种有价值的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd72/6664580/f7dbd6175f3b/12886_2019_1172_Fig1_HTML.jpg

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