J Refract Surg. 2021 Mar;37(3):180-185. doi: 10.3928/1081597X-20201222-01. Epub 2021 Mar 18.
To describe a new scleral fixation technique potentially usable for every acrylic foldable intraocular lens (IOL) available in the market, regardless of whether it is a three-piece, single-piece, or haptic shape.
Before surgery, the authors performed the transfixion of the IOL optic in four points with the polytetrafluoroethylene suture under a surgical microscope. Four sclerotomy sites were marked 2 mm from the limbus, and two scleral grooves were created in between. The IOL was introduced into the posterior chamber. The four ends of the needleless polytetrafluoroethylene sutures were externalized through the sclerotomies, tightened for optimum IOL centration, and tied. The exposed sutures were placed within the scleral grooves, and the knots were buried within the sclerotomies. This technique was performed uneventfully in 7 cases.
The foldable IOL was stable in all eyes 6 months after surgery, with no signs of IOL subluxation, dislocation, tilt, or suture-related complications, such as erosion or infection.
The transfixion of the foldable posterior chamber IOL for stable four-point scleral fixation using a polytetrafluoroethylene suture provides excellent stability and prevents IOL tilt and decentration. This technique can immensely benefit patients requiring secondary foldable posterior chamber IOL implantation in the absence of capsular support. .
描述一种新的巩膜固定技术,该技术可能适用于市场上所有的丙烯酸可折叠人工晶状体(IOL),无论其是三部分式、一体式还是襻形状。
手术前,作者在手术显微镜下用聚四氟乙烯缝线在四点处对 IOL 光学部进行贯穿固定。在距角膜缘 2mm 处标记四个巩膜切口点,并在其间创建两个巩膜槽。将 IOL 引入后房。将无针聚四氟乙烯缝线的四个末端通过巩膜切口引出,拉紧以实现最佳的 IOL 居中,并结扎。将暴露的缝线放置在巩膜槽内,并将结埋在巩膜切口中。该技术在 7 例病例中顺利进行。
手术后 6 个月,所有眼睛的折叠式 IOL 均稳定,无 IOL 半脱位、脱位、倾斜或与缝线相关的并发症(如侵蚀或感染)的迹象。
使用聚四氟乙烯缝线对折叠式后房 IOL 进行贯穿固定,以实现四点巩膜稳定固定,可提供极佳的稳定性,并防止 IOL 倾斜和偏心。对于需要在缺乏囊袋支持的情况下进行二次折叠式后房 IOL 植入的患者,该技术有很大的益处。