Torii Toshiki, Tamaoki Akeno, Kojima Takashi, Matsuda Taisuke, Kaga Tatsushi, Ichikawa Kazuo
Department of Ophthalmology, Japan Community Health Care Organization, Chukyo Hospital, Nagoya, Japan.
Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
Clin Ophthalmol. 2020 Nov 17;14:3965-3974. doi: 10.2147/OPTH.S268126. eCollection 2020.
To compare the clinical outcomes of intrascleral intraocular lens (IOL) fixation surgery with those of intracapsular IOL implantation in conventional cataract surgery.
Twenty-one eyes of 21 consecutive patients who underwent intrascleral IOL fixation (SF group) and 21 eyes of 21 patients who underwent IOL intracapsular implantation during cataract surgery (IN group) were retrospectively enrolled. For both groups, the same model of IOL was used in all cases. For all cases in the SF group, Yamane's double-needle technique was performed.
The mean corrected visual acuity (logMAR) after surgery was significantly better in the IN than in the SF group (-0.063 ± 0.12 vs 0.05 ± 0.14; p = 0.0083). The mean anterior chamber depth after surgery was significantly smaller in the IN than in the SF group (4.65 ± 0.23 mm vs 4.98 ± 0.61 mm; p = 0.0231). The amounts of tilt and decentration were also significantly smaller in the IN group (5.21°± 1.47° and 0.22 ± 0.13 mm, respectively, vs 8.8° ± 3.9° and 0.52 ± 0.35 mm, respectively; p = 0.0003 and p = 0.0007). The mean absolute refractive prediction error was significantly smaller in the IN than in the SF group (0.22 ± 0.17 D vs 0.86 ± 0.59 D; p = 0.0002).
The intrascleral IOL fixation surgery proved to be highly effective. However, its clinical outcomes were slightly inferior to those of IOL intracapsular implantation, and further improvement of this surgical technique may be needed.
比较巩膜内人工晶状体（IOL）固定手术与传统白内障手术中囊内IOL植入术的临床效果。
回顾性纳入21例连续接受巩膜内IOL固定术的患者的21只眼（SF组）以及21例在白内障手术期间接受IOL囊内植入术的患者的21只眼（IN组）。两组所有病例均使用相同型号的IOL。SF组所有病例均采用山根双针法。
术后平均矫正视力（logMAR）在IN组显著优于SF组（-0.063±0.12 vs 0.05±0.14；p = 0.0083）。术后平均前房深度在IN组显著小于SF组（4.65±0.23mm vs 4.98±0.61mm；p = 0.0231）。IN组的倾斜度和偏心度也显著更小（分别为5.21°±1.47°和0.22±0.13mm，而SF组分别为8.8°±3.9°和0.52±0.35mm；p = 0.0003和p = 0.0007）。平均绝对屈光预测误差在IN组显著小于SF组（0.22±0.17D vs 0.86±0.59D；p = 0.0002）。
巩膜内IOL固定手术被证明是高度有效的。然而，其临床效果略逊于IOL囊内植入术，可能需要进一步改进该手术技术。
