Hu Xin, Zhao Bo, Jin Haiying
Department of Ophthalmology, Huaihe Hospital, Henan University, Kaifeng 475000, China.
Department of Ophthalmology, Shanghai Tenth People's Hospital Affiliated to Shanghai Tongji University School of Medicine, Shanghai 200072, China.
J Ophthalmol. 2020 Dec 1;2020:6642007. doi: 10.1155/2020/6642007. eCollection 2020.
We describe a minimally invasive suture fixation technique for four-point fixation of intraocular lenses (IOLs) in the treatment of aphakic eyes, namely, the intrascleral suture anchoring technique. Neither scleral flaps nor large conjunctival dissections are required.
This study included 11 eyes (11 patients). After looping the eyelets on the IOL haptics and externalizing the threads, the curved needle attached to the externalized thread was started with two sequential intrascleral passes from the first fixation point to reach the second fixation point. The same procedure was performed for the other side of the IOL. A fixation knot was created in the sclerotomy by the two ends of the thread to close the suture loop for IOL fixation. Another knot was created about 2 to 3 mm from the exiting point and was intrasclerally anchored by the aid of the attached curved needle.
The mean postoperative follow-up period was 9.7 ± 5.8 months (range 5-15 months). The IOLs of all eyes remained well positioned and stable postoperatively. The postoperative visual acuities were improved. No suture erosion, suture loosening, hypotony, scleral atrophy, chronic inflammation, retinal tear, and/or detachment were observed within the follow-up period.
The present technique is an alternative, flapless method for the four-point suture fixation of IOLs. It provides both minimal surgical trauma and reliable stability.
我们描述一种用于无晶状体眼人工晶状体（IOL）四点固定的微创缝合固定技术，即巩膜内缝合锚定技术。该技术无需制作巩膜瓣或进行大范围的结膜分离。
本研究纳入11只眼（11例患者）。在IOL襻上环绕小孔并引出缝线后，将连接引出缝线的弯针从第一个固定点开始，连续两次穿过巩膜到达第二个固定点。IOL的另一侧也进行同样的操作。通过缝线两端在巩膜切口处打一个固定结，以闭合用于IOL固定的缝线环。在缝线穿出点约2至3毫米处再打一个结，并借助连接的弯针将其在巩膜内固定。
术后平均随访时间为9.7±5.8个月（范围5至15个月）。所有眼的IOL术后位置良好且稳定。术后视力得到改善。随访期间未观察到缝线侵蚀、缝线松动、低眼压、巩膜萎缩、慢性炎症、视网膜裂孔和/或视网膜脱离。
本技术是一种用于IOL四点缝合固定的替代方法，无需制作瓣。它既能提供最小的手术创伤，又能保证可靠的稳定性。
