Eye Clinic, Department of Biomedical and Clinical Sciences "Luigi Sacco", Luigi Sacco Hospital, University of Milan, Milan, Italy.
Graefes Arch Clin Exp Ophthalmol. 2021 May;259(5):1365-1373. doi: 10.1007/s00417-020-04980-6. Epub 2020 Oct 22.
Comparing two different sutureless scleral fixation techniques.
A retrospective study of patients who underwent sutureless scleral fixation IOL from October 2013 to May 2018 at "Luigi Sacco Hospital", University of Milan. Comparison between two groups: Group 1 implanted with a 3-piece ALCON-MA60AC and group 2 implanted with a newly developed single-piece foldable IOL SOLEKO FIL-SSF. Patients underwent a complete preoperative ophthalmic assessment and post-operative evaluation at 1, 3, and 6 months. Vitrectomy was performed in all cases. The two groups were compared for age, axial length, and lens status at baseline. Visual acuity, refractive results, surgical time, and post-operative complications were recorded.
Thirty-one eyes were included: group 1, 15 eyes of 15 patients, and group 2, 16 eyes of 14 patients. No difference was found in visual acuity. Mean refractive error was 1D in both groups (group 1 1.01D, group 2 1.09D), but spherical equivalent was more often moved toward negative values and induced astigmatism was greater in the 3-piece group (group 1 1.91D [SD ± 2.07], group 2 0.67D [SD ± 0.88] P = 0.04). Surgical procedure was faster in group 2 (mean time difference 21', P = 0.01*). New displacement occurred in 5 cases (33%) of group 1 and in no cases of group 2 (P = 0.01*). Post-operative bleeding was registered only in group 1 (20%), but the difference was not statistically significant.
The group 2 IOL gives in our sample better results due to less post-operative astigmatism and reducing dislocation and bleeding during follow-up. Surgical technique appeared easier and faster: the specifically designed IOL seems to be a feasible solution for sutureless scleral fixation.
比较两种不同的免缝线巩膜固定技术。
这是一项回顾性研究，选取 2013 年 10 月至 2018 年 5 月在米兰大学 Luigi Sacco 医院接受免缝线巩膜固定 IOL 的患者。比较两组患者：第 1 组植入了 Alcon-MA60AC 的三件式人工晶状体，第 2 组植入了新开发的单片折叠式人工晶状体 SOLEKO FIL-SSF。所有患者均接受了全面的术前眼科评估，并在术后 1、3 和 6 个月进行了评估。所有病例均行玻璃体切除术。比较两组患者的年龄、眼轴长度和基线时晶状体状态。记录视力、屈光结果、手术时间和术后并发症。
共纳入 31 只眼：第 1 组 15 只眼，共 15 例患者；第 2 组 16 只眼，共 14 例患者。两组患者的视力无差异。两组的平均屈光误差均为 1D（第 1 组 1.01D，第 2 组 1.09D），但 3 件式组的等效球镜度数更常向负值移动，诱导的散光更大（第 1 组 1.91D [SD ± 2.07]，第 2 组 0.67D [SD ± 0.88]，P = 0.04）。第 2 组的手术时间更快（平均时间差 21'，P = 0.01*）。第 1 组有 5 例（33%）发生新的移位，而第 2 组无病例发生（P = 0.01*）。仅在第 1 组（20%）观察到术后出血，但差异无统计学意义。
在我们的样本中，第 2 组的 IOL 由于术后散光较小、随访期间脱位和出血减少，结果更好。手术技术似乎更容易和更快：专门设计的 IOL 似乎是免缝线巩膜固定的可行解决方案。
