Deb Amit Kumar, Sarkar Sandip, Natarajan Kaviyapriya, Elamurgan Vignesh, Jayaseelan Jagadeeswari, Gokhale Tanmay, Jacob Ninan
Department of Ophthalmology, Jawaharlal Institute of Postgraduate Medical Education & Research, Gorimedu, India.
Senior Resident, Department of Ophthalmology, Jawaharlal Institute of Postgraduate Medical Education & Research, Gorimedu 605006, Puducherry, India.
Ther Adv Ophthalmol. 2021 Apr 20;13:25158414211009095. doi: 10.1177/25158414211009095. eCollection 2021 Jan-Dec.
The aim of this study is to describe the complications and outcome of sutureless scleral fixated intraocular lens (SFIOL) implantation in traumatic aphakia.
The study was conducted in a tertiary eye care centre in South India.
The study involved a retrospective data analysis.
Medical records of cases with traumatic aphakia who had undergone sutureless SFIOL implantation in the last 2 years were included in the study. Data on intraoperative and postoperative complications and visual outcome were collected and analysed.
In total, 45 cases were recruited. Mean logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA) improved from preoperative 1.64 ± 0.45 to 0.63 ± 0.36 at last follow-up visit, and the difference was statistically significant ( < 0.0001). Final logMAR BCVA was worse than one in three patients who had associated posterior segment pathology. There was no incidence of intraoperative haptic rebound into the vitreous cavity or intraocular lens (IOL) drop. Four cases had hypotony, two cases had choroidal detachment, four cases had raised intraocular pressure (IOP), eight cases had transient corneal oedema and six patients had mild dispersed vitreous haemorrhage during immediate postoperative period. Six patients had postoperative cystoid macular oedema (CME). Two cases developed glaucoma. None of the patients had postoperative haptic exposure, retinal detachment (RD), iris capture of IOL or SFIOL dislocation till the last follow-up.
Final visual outcome of sutureless SFIOL implantation in traumatic aphakia may be affected by concomitant posterior segment pathology. The immediate and late postoperative complications noted in our study were comparable with other similar studies. However, longer follow-up is needed to detect RD and angle recession glaucoma at the earliest and initiate therapy.
本研究旨在描述外伤性无晶状体眼行无缝线巩膜固定人工晶状体（SFIOL）植入术的并发症及预后。
本研究在印度南部的一家三级眼科护理中心进行。
本研究采用回顾性数据分析。
纳入过去2年接受无缝线SFIOL植入术的外伤性无晶状体眼病例的医疗记录。收集并分析术中及术后并发症和视力预后的数据。
共纳入45例病例。最小分辨角对数（logMAR）最佳矫正视力（BCVA）从术前的1.64±0.45提高到最后一次随访时的0.63±0.36，差异有统计学意义（<0.0001）。最终logMAR BCVA在三分之一伴有后段病变的患者中较差。术中未发生襻弹入玻璃体腔或人工晶状体（IOL）脱位的情况。4例发生低眼压，2例发生脉络膜脱离，4例眼压升高（IOP），8例术后即刻出现短暂性角膜水肿，6例患者出现轻度弥漫性玻璃体出血。6例患者发生术后黄斑囊样水肿（CME）。2例发生青光眼。直至最后一次随访，无一例患者发生术后襻暴露、视网膜脱离（RD）、IOL虹膜夹持或SFIOL脱位。
外伤性无晶状体眼行无缝线SFIOL植入术的最终视力预后可能受合并的后段病变影响。我们研究中观察到的术后即刻和晚期并发症与其他类似研究相当。然而，需要更长时间的随访以尽早发现RD和房角后退性青光眼并启动治疗。
