From the Center for Applied Eye Research (Assia, Wong), Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel, affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Ein-Tal Eye Center (Wong), Tel Aviv, Israel; National Healthcare Group Eye Institute (Wong), Tan Tock Seng Hospital, Singapore.
J Cataract Refract Surg. 2020 Oct;46(10):1387-1391. doi: 10.1097/j.jcrs.0000000000000260.
To describe the technique and outcomes of modified adjustable flange intrascleral fixation using 6-0 polypropylene sutures in primary scleral fixation in a variety of intraocular lenses (IOLs) and capsular stabilizing devices.
Center for Applied Eye Research, Meir Medical Center, Israel.
Case series.
Laboratory studies were performed to test the feasibility of passing 6-0 polypropylene sutures through hydrophobic and hydrophilic IOLs. The durability of the IOL, suture, and created flange was tested. IOL implantation was performed first on porcine eyes with assessment of IOL position. Surgery was then performed using this adjustable flange technique using a variety of IOLs, including hydrophilic, hydrophobic, and poly(methyl methacrylate) aniridic IOLs and the capsular anchor (AssiAnchor) to stabilize the capsular lens in eyes with compromised zonular fibers.
Surgery was performed on 9 eyes. Both hydrophobic and hydrophilic IOLs together with the 6-0 polypropylene suture were sufficiently durable in laboratory tests. Intrascleral fixation of 3 hydrophobic IOLs and 1 hydrophilic IOL was successfully achieved in 4 aphakic eyes. Stable and secure capsular bag fixation using the AssiAnchor was achieved in 4 eyes. Fixation of an aniridia IOL was also performed with success in 1 eye. All cases had stable and securely fixated IOLs and good postoperative recovery at 3 months follow-up. There was improvement in uncorrected distance visual acuity postoperatively in all cases.
The modified adjustable flange technique for scleral fixation using polypropylene 6-0 was effective, relatively quick, and technically simpler and safer than alternative methods in the management of aphakia and zonular instability.
描述使用 6-0 聚丙烯缝线在各种人工晶状体 (IOL) 和囊袋稳定装置中进行原发性巩膜固定的改良可调翼片巩膜内固定技术和结果。
以色列梅尔医疗中心应用眼研究中心。
病例系列。
进行实验室研究以测试 6-0 聚丙烯缝线穿过疏水性和亲水性 IOL 的可行性。测试了 IOL、缝线和创建的翼片的耐用性。首先在猪眼上进行 IOL 植入，并评估 IOL 位置。然后使用这种可调翼片技术进行手术，使用各种 IOL，包括亲水、疏水和聚甲基丙烯酸甲酯无虹膜 IOL 以及囊袋锚 (AssiAnchor)，以稳定有脆弱悬韧带的眼睛中的囊袋晶状体。
对 9 只眼睛进行了手术。亲水性和疏水性 IOL 以及 6-0 聚丙烯缝线在实验室测试中均具有足够的耐用性。在 4 只无晶状体眼中成功实现了 3 只疏水 IOL 和 1 只亲水 IOL 的巩膜内固定。在 4 只眼中成功实现了使用 AssiAnchor 稳定且安全的囊袋固定。在 1 只眼睛中也成功地进行了无虹膜 IOL 的固定。所有病例均具有稳定且安全固定的 IOL，术后 3 个月随访时恢复良好。所有病例的未矫正远视力均有改善。
使用聚丙烯 6-0 的改良可调翼片巩膜固定技术对于处理无晶状体和悬韧带不稳定是有效、相对快速且技术上更简单、更安全的方法。
