Gabai Andrea, Zeppieri Marco, Toneatto Giacomo, Salati Carlo
From the Department of Ophthalmology, University Hospital of Udine, Udine, Italy.
J Cataract Refract Surg. 2021 Dec 1;47(12):e75-e79. doi: 10.1097/j.jcrs.0000000000000700.
A simplified intrascleral fixation technique involving implantation of the Carlevale intraocular lens (IOL) in the posterior chamber is described, which lodges the T-shaped IOL haptics in the scleral wall, not requiring scleral flaps. This surgical modification reduces operative time, limits iatrogenic damage to the sclera, and avoids friction between haptics and the conjunctiva, which may cause conjunctival erosion and infection in the long term. 13 patients with crystalline lens or IOL dislocation/subluxation had surgery to implant the Carlevale IOL in the posterior chamber. Mean corrected distance visual acuity preoperatively was 0.75 ± 0.5 logMAR (range, 0.2 to 1.5 logMAR) and improved to 0.28 ± 0.3 logMAR (range, 0 to 1.0 logMAR) postoperatively. Complications rarely occurred and were not sight-threatening. The sutureless scleral fixation of the Carlevale IOL using the modified surgical technique may represent a safe and effective procedure to restore visual function in patients with damaged zonular-capsular support.
本文描述了一种简化的巩膜内固定技术，即将卡莱瓦尔人工晶状体（IOL）植入后房，该技术将T形IOL袢置于巩膜壁内，无需制作巩膜瓣。这种手术改良减少了手术时间，限制了对巩膜的医源性损伤，并避免了袢与结膜之间的摩擦，长期来看，这种摩擦可能导致结膜糜烂和感染。13例晶状体或IOL脱位/半脱位患者接受了将卡莱瓦尔IOL植入后房的手术。术前平均矫正远视力为0.75±0.5 logMAR（范围为0.2至1.5 logMAR），术后提高至0.28±0.3 logMAR（范围为0至1.0 logMAR）。并发症很少发生，且不威胁视力。采用改良手术技术对卡莱瓦尔IOL进行无缝线巩膜固定，可能是恢复悬韧带-晶状体囊膜支持受损患者视觉功能的一种安全有效的方法。
