Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, People's Republic of China ; and.
Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, People's Republic of China .
Retina. 2023 Jun 1;43(6):1019-1023. doi: 10.1097/IAE.0000000000002876. Epub 2020 Jun 26.
To describe a modified intrascleral fixation technique for repositioning single-piece rigid polymethyl methacrylate intraocular lenses (IOLs).
Four patients with dislocated IOLs were enrolled. Surgical modifications included using ≤1-mm scleral incision for haptic externalization, placing the IOL haptic placement in scleral tunnels, and using 8-0 absorbable sutures. Patients were followed up for 6 months with routine ophthalmic examinations, corneal endothelial cell counts, and ultrasound biomicroscopy (UBM).
The mean follow-up time was 13.5 ± 5.45 months. The IOL was well centered and the spherical refraction improved (+10.25 ± 2.21 vs. -0.81 ± 1.59 D, P < 0.05), whereas the best-corrected visual acuity (pre 20/43 Snellen, 0.42 ± 0.33 logarithm of the minimum angle of resolution equivalent and post 20/36 Snellen, 0.31 ± 0.22 logarithm of the minimum angle of resolution equivalent; P = 0.235), intraocular pressure (pre 13.8 ± 3.21, post 13.55 ± 5.14 mmHg), corneal endothelium density (pre 2,423.8 ± 279.6/mm 2 , post 2,280.25 ± 350.7/mm 2 ), and total astigmatism (pre -1.94 ± 0.43, post -1.69 ± 0.59 D) remained unchanged. The average horizontal and vertical IOL tilt was 0.33 ± 0.22° and 0.81 ± 0.38°, respectively. Intraocular lens decentration was 0.10 ± 0.03 mm horizontally and 0.13 ± 0.06 mm vertically.
The modified intrascleral fixation technique shows encouraging midterm results in patients with dislocated single-piece, rigid polymethyl methacrylate IOLs. Larger samples and longer follow-up are required to confirm the outcomes of this technique.
描述一种改良的巩膜内固定技术，用于重新定位单片硬性聚甲基丙烯酸甲酯人工晶状体（IOL）。
纳入 4 例晶状体脱位患者。手术改良包括使用≤1mm 的巩膜切口进行巩膜外展、将 IOL 襻放置在巩膜隧道内以及使用 8-0 可吸收缝线。患者接受了 6 个月的常规眼科检查、角膜内皮细胞计数和超声生物显微镜（UBM）检查。
平均随访时间为 13.5±5.45 个月。IOL 居中良好，球镜屈光度提高（+10.25±2.21 与-0.81±1.59 D，P＜0.05），而最佳矫正视力（术前 20/43 视力表，0.42±0.33 对数最小分辨角视力等效值，术后 20/36 视力表，0.31±0.22 对数最小分辨角视力等效值；P=0.235）、眼内压（术前 13.8±3.21mmHg，术后 13.55±5.14mmHg）、角膜内皮细胞密度（术前 2,423.8±279.6/mm2，术后 2,280.25±350.7/mm2）和总散光（术前-1.94±0.43D，术后-1.69±0.59D）均无变化。IOL 平均水平和垂直倾斜度分别为 0.33±0.22°和 0.81±0.38°。IOL 偏心度为水平 0.10±0.03mm 和垂直 0.13±0.06mm。
改良的巩膜内固定技术在晶状体脱位的单片硬性聚甲基丙烯酸甲酯 IOL 患者中显示出令人鼓舞的中期结果。需要更大的样本量和更长的随访时间来确认该技术的结果。
