University of Missouri-Kansas City School of Medicine, Kansas City, Missouri.
Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas.
Retina. 2021 May 1;41(5):940-946. doi: 10.1097/IAE.0000000000002991.
To compare the visual outcomes and complication rates of sutureless cannula-based intraocular lens scleral (SCILS) fixation performed with 25-gauge (25 G) versus 27-gauge (27 G) instrumentation.
A retrospective chart review of consecutive cases of eyes without capsular support that underwent SCILS fixation of a three-piece intraocular lens. Sutureless cannula-based intraocular lens scleral fixation was performed by transconjunctival use of either 25-G or 27-G trocar cannulas. During postoperative follow-up evaluations, visual acuity and intraocular pressure were measured, and slit-lamp and indirect ophthalmoscopy examinations were performed to assess for development of known complications.
A total of 69 eyes underwent 25 G (27 eyes) or 27 G (42 eyes) SCILS fixation. The mean preoperative logarithm of the minimum angle of resolution visual acuity trended toward improvement from 0.95 ± 0.68 (20/178 Snellen equivalent) to 0.67 ± 0.64 (20/94 Snellen equivalent) for 25 G group at 1 year. Similar trend toward visual acuity improvement was seen in 27 G group with a mean preoperative logarithm of the minimum angle of resolution visual acuity of 1.43 ± 0.94 (20/538 Snellen equivalent) improving to 0.86 ± 1.00 (20/145 Snellen equivalent) at 1 year. Statistically significant improvement was seen as early as postoperative week one for 27 G group (P < 0.01), whereas statistically significant worsening was noted at the same time in 25 G group (P = 0.01). There was a statistically significant reduction in intraocular lens displacement (P = 0.01) and need for reoperation (P = 0.01) in 27 G group.
Compared with 25 G SCILS fixation, eyes managed with 27 G SCILS fixation experienced more rapid visual acuity improvement. In addition, there was a lower rate of complications including intraocular lens displacement and need for reoperation.
比较 25G（25 规）与 27G（27 规）器械行无缝线套管基人工晶状体巩膜固定术的视力结果和并发症发生率。
对连续行无晶状体囊支持的眼行三襻式人工晶状体 SCILS 固定术的病例进行回顾性图表分析。使用经结膜的 25G 或 27G 套管穿刺器行无缝线套管基人工晶状体巩膜固定术。在术后随访评估中，测量视力和眼压，并进行裂隙灯和间接检眼镜检查，以评估已知并发症的发生情况。
共有 69 只眼接受了 25G（27 只眼）或 27G（42 只眼）SCILS 固定术。25G 组的平均术前最小分辨角对数视力从 0.95±0.68（20/178 视力表等价）趋向于在 1 年时改善至 0.67±0.64（20/94 视力表等价）。27G 组也呈现出类似的视力改善趋势，术前最小分辨角对数视力的平均值为 1.43±0.94（20/538 视力表等价），在 1 年时改善至 0.86±1.00（20/145 视力表等价）。27G 组在术后第 1 周即出现统计学显著的改善（P<0.01），而 25G 组在同一时间出现统计学显著的恶化（P=0.01）。27G 组的人工晶状体移位（P=0.01）和需要再次手术（P=0.01）显著减少。
与 25G SCILS 固定术相比，27G SCILS 固定术的眼视力恢复更快。此外，并发症发生率包括人工晶状体移位和需要再次手术的发生率更低。
