Donnadieu B, Comet A, Gascon P, Ramtohul P, Callet M, Denis D, Matonti F
Assistance Publique-Hôpitaux de Marseille, centre hospitalier universitaire NORD, chemin des Bourrely, 13015 Marseille, France.
Assistance Publique-Hôpitaux de Marseille, centre hospitalier universitaire NORD, chemin des Bourrely, 13015 Marseille, France.
J Fr Ophtalmol. 2020 Apr;43(4):312-318. doi: 10.1016/j.jfo.2019.08.013. Epub 2020 Feb 27.
A certain number of conditions can result in compromised anterior and/or posterior capsular integrity. Several surgical options have been employed for repositioning dislocated intraocular lenses in the absence of adequate capsular support. The purpose of this study is to assess the functional outcomes and complication profile of a modified surgical technique for replacing dislocated intraocular lenses.
All patients who had undergone the modified surgical procedure for dislocated intraocular lenses between 2012 and 2017 were retrospectively reviewed for visual outcomes and complications. Patient demographic characteristics, pre- and postoperative visual acuity, surgical indications, refractive outcomes, intraocular pressure and postoperative complications were recorded and analysed at baseline and at six months, which was the conclusion of the study. We also present our modified surgical technique.
Sixty-eight eyes of sixty-eight patients (74% male) were included. Mean age at surgery was 58 years (range 4-89 years). Mean best-corrected visual acuity increased significantly from 0.80 (SD±0.2) LogMar to 0.40 (SD±0.1) LogMar (P<0.005). Median astigmatic error at the conclusion of follow-up remained stable. There were no intraoperative complications and a low postoperative complication rate (10.2%), mainly related to the surgical context.
Sutureless intrascleral fixation of dislocated intraocular lenses is an option in case of deficient capsular support. Visual outcomes and complication rates are comparable to other case series.
一定数量的情况可导致前囊和/或后囊完整性受损。在缺乏足够囊膜支撑的情况下，已采用多种手术方法来重新定位脱位的人工晶状体。本研究的目的是评估一种改良手术技术用于置换脱位人工晶状体的功能结局和并发症情况。
回顾性分析2012年至2017年间所有接受改良脱位人工晶状体手术患者的视力结局和并发症。记录并分析患者的人口统计学特征、术前和术后视力、手术指征、屈光结局、眼压及术后并发症，研究起始时及研究结束时（六个月时）作为基线数据。我们还展示了我们的改良手术技术。
纳入68例患者的68只眼（男性占74%）。手术时的平均年龄为58岁（范围4 - 89岁）。平均最佳矫正视力从0.80（标准差±0.2）LogMar显著提高至0.40（标准差±0.1）LogMar（P<0.005）。随访结束时散光误差中位数保持稳定。术中无并发症，术后并发症发生率低（10.2%），主要与手术背景相关。
对于囊膜支撑不足的情况，脱位人工晶状体的无缝合巩膜内固定是一种选择。视力结局和并发症发生率与其他病例系列相当。
