Wu Kaicheng, Zong Yuan, Yu Jian, Fang Wangyi, Jiang Chunhui, Xu Gezhi
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 Aug 1;43(8):1408-1412. doi: 10.1097/IAE.0000000000002987.
To describe a novel technique for capsular bag reopening and secondary in-the-bag intraocular lens (IOL) implantation in aphakic eyes after vitreoretinal surgery and intraocular tamponade.
We enrolled 14 eyes of 14 patients who underwent primary vitreoretinal surgery with silicone oil tamponade for rhegmatogenous retinal detachment between September 2018 and September 2019. The novel technique was used for capsular bag reopening and foldable single-piece IOL implantation. Patients were followed up at least 24 weeks with routine ophthalmic examinations, corneal endothelial cell density, and IOL tilt and decentration measurement.
The procedure was successfully completed in 13 cases; in one case, because of posterior capsular tear, the IOL was implanted with ciliary sulcus fixation. After a mean follow-up of 48.8 ± 14.8 (range, 24.9-65.9) weeks, the best-corrected visual acuity (before 20/76 Snellen, 0.63 ± 0.23 logarithm of the minimum angle of resolution equivalent and after 20/35 Snellen, 0.32 ± 0.32 logarithm of the minimum angle of resolution equivalent; P = 0.001) and spherical equivalent (before +8.22 ± 4.08, after -2.39 ± 1.77 D; P < 0.001) improved, intraocular pressure (before 15.93 ± 4.40, after 16.25 ± 4.25 mmHg; P = 0.743) remained unchanged. The IOL was well centered with a mean horizontal and vertical tilt of 0.5070 ± 0.3319° and 0.4652 ± 0.3465°, respectively, and decentration of 0.1705 ± 0.1334 mm and 0.1712 ± 0.1576 mm, respectively.
With this technique, capsular bag reopening and secondary in-the-bag IOL implantation could be achieved in most cases with satisfactory visual outcome and IOL position.
描述一种用于玻璃体视网膜手术及眼内填充术后无晶状体眼的囊袋重新打开及二期囊袋内人工晶状体（IOL）植入的新技术。
我们纳入了2018年9月至2019年9月期间因孔源性视网膜脱离接受硅油填充的一期玻璃体视网膜手术的14例患者的14只眼。采用该新技术进行囊袋重新打开及可折叠单片式IOL植入。患者接受至少24周的随访，包括常规眼科检查、角膜内皮细胞密度以及IOL倾斜和偏心测量。
13例手术成功完成；1例因后囊膜撕裂，IOL通过睫状沟固定植入。平均随访48.8±14.8（范围24.9 - 65.9）周后，最佳矫正视力（术前20/76 Snellen，最小分辨角对数等效值为0.63±0.23，术后20/35 Snellen，最小分辨角对数等效值为0.32±0.32；P = 0.001）和球镜等效度（术前+8.22±4.08，术后-2.39±1.77 D；P < 0.001）改善，眼压（术前15.93±4.40，术后16.25±4.25 mmHg；P = 0.743）保持不变。IOL居中良好，平均水平倾斜和垂直倾斜分别为0.5070±0.3319°和0.4652±0.3465°，偏心分别为0.1705±0.1334 mm和0.1712±0.1576 mm。
采用该技术，大多数情况下可实现囊袋重新打开及二期囊袋内IOL植入，视觉效果和IOL位置令人满意。
