From the Department of Ophthalmology, Oslo University Hospital, Oslo, Norway (Dalby, Drolsum, Kristianslund); Institute of Clinical Medicine, University of Oslo, Oslo, Norway (Dalby, Drolsum, Kristianslund).
J Cataract Refract Surg. 2021 Sep 1;47(9):1147-1152. doi: 10.1097/j.jcrs.0000000000000588.
To evaluate the long-term efficacy and safety after intraocular lens (IOL) repositioning by scleral suturing of 1-piece IOL compared with other IOL designs in the treatment of late in-the-bag IOL dislocation.
Patients referred to Oslo University Hospital Oslo, Norway.
Prospective cohort study.
The study comprised 54 patients (54 eyes) with late in-the-bag IOL dislocation treated with IOL repositioning by scleral sutures (10-0 polypropylene). All operations were performed with an anterior approach and by 1 surgeon. The following IOL designs were repositioned: 1-piece foldable (n = 17), 3-piece foldable (n = 28), plate-haptic (n = 8), and 1-piece rigid (n = 1) IOLs. Patients were evaluated comprehensively preoperatively and at 6 months (80%), 1 year (67%), and 2 years (61%) postoperatively. The main outcome measures were efficacy regarding corrected distance visual acuity (CDVA) and spherical equivalent (SE) and safety regarding complications.
Postoperative visual acuity was similar for different IOL designs. The mean SE change to final observation was -0.08 (95% CI, -0.93 to 0.77) in the 1-piece IOL group (n = 11) and -0.98 (-1.73 to -0.23) in the 3-piece IOL group (n = 18) (P = .11). Regarding safety, no patients had uveitis-glaucoma-hyphema syndrome, retinal detachment, or endophthalmitis. The 3-piece IOL group had 1 case of redislocation and 1 case of iritis. No patients had symptoms related to clinical IOL decentration. Long-term intraocular pressure remained within normal limits with overlapping 95% CIs for different IOLs.
Repositioning surgery of 1-piece IOLs seems as efficient and safe as that for other IOL designs in the treatment of late in-the-bag IOL dislocation.
评估巩膜缝线固定 1 件式人工晶状体（IOL）与其他 IOL 设计相比治疗迟发性囊袋内 IOL 脱位的长期疗效和安全性。
挪威奥斯陆大学医院的患者。
前瞻性队列研究。
本研究包括 54 例（54 只眼）迟发性囊袋内 IOL 脱位患者，采用巩膜缝线固定 IOL（10-0 聚丙烯）进行治疗。所有手术均由同一位外科医生采用前房入路进行。重新定位的 IOL 设计如下：1 件式折叠（n = 17）、3 件式折叠（n = 28）、板状触觉（n = 8）和 1 件式刚性（n = 1）IOL。患者在术前和术后 6 个月（80%）、1 年（67%）和 2 年（61%）进行全面评估。主要观察指标为矫正远视力（CDVA）和等效球镜（SE）的疗效以及并发症的安全性。
不同 IOL 设计的术后视力相似。1 件式 IOL 组（n = 11）最终观察时 SE 平均变化为-0.08（95%CI，-0.93 至 0.77），3 件式 IOL 组（n = 18）为-0.98（-1.73 至-0.23）（P =.11）。关于安全性，没有患者发生葡萄膜炎-青光眼-前房积血综合征、视网膜脱离或眼内炎。3 件式 IOL 组有 1 例复发性脱位和 1 例虹膜炎。没有患者出现与临床 IOL 偏心相关的症状。不同 IOL 的长期眼内压仍在正常范围内，95%CI 重叠。
1 件式 IOL 复位手术治疗迟发性囊袋内 IOL 脱位的效果和安全性与其他 IOL 设计相似。
