Yoshida Norihiko, Kojima Takashi, Ichikawa Kazuo
Department of Ophthalmology, Japanese Red Cross Gifu Hospital, Gifu, Japan.
Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
Clin Ophthalmol. 2021 Jul 6;15:2885-2892. doi: 10.2147/OPTH.S320460. eCollection 2021.
In this study, we aimed to report on the early results of intrascleral intraocular lens (IOL) fixation using a hook-shaped haptic IOL (hsh-IOL).
We enrolled 27 consecutive eyes of 27 patients (mean age, 74±11.4 years) who underwent intrascleral IOL fixation with an hsh-IOL and were followed-up for 3 months postoperatively. The reasons for surgery included insufficient capsular support, including IOL dislocation, aphakia, or dislocated crystalline lens. The haptic of the hsh-IOL was externalized from the eye using forceps, and the hook was buried in the scleral tunnel. We investigated the preoperative and 3-month postoperative corrected visual acuity (VA), intraocular pressure (IOP), corneal endothelial cell density, refractive prediction error, postoperative intraocular astigmatism, surgically induced astigmatism, and intraoperative and postoperative complications.
The mean postoperative corrected VA (logMAR, 0.083±0.18) was significantly better than the mean preoperative value (0.42±0.60, p=0.0007). The 3-month postoperative mean absolute prediction error was 1.00±0.96 D. The mean IOL-induced astigmatism was 0.95±0.70 D. Further, the mean postoperative corneal endothelial cell count (2036±644 cells/mm) was significantly lower than the preoperative value (2316±527 cells/mm) (p=0.009). No patient had a 1-month postoperative IOP <5 mmHg or >25 mmHg. There were no intraoperative or vision-threatening complications, such as retinal detachment, endophthalmitis, or IOL dislocation, due to postoperative haptics misalignment.
Intrascleral IOL fixation using hsh-IOL is an effective option for eyes with insufficient capsular support.
在本研究中，我们旨在报告使用钩状襻人工晶状体（hsh-IOL）进行巩膜内人工晶状体（IOL）固定术的早期结果。
我们纳入了27例患者的27只连续眼睛（平均年龄74±11.4岁），这些患者接受了hsh-IOL巩膜内IOL固定术，并在术后随访3个月。手术原因包括囊袋支撑不足，包括IOL脱位、无晶状体眼或晶状体脱位。使用镊子将hsh-IOL的襻从眼内引出，将钩埋入巩膜隧道。我们调查了术前和术后3个月的矫正视力（VA）、眼压（IOP）、角膜内皮细胞密度、屈光预测误差、术后眼内散光、手术性散光以及术中和术后并发症。
术后平均矫正视力（logMAR，0.083±0.18）显著优于术前平均值（0.42±0.60，p = 0.0007）。术后3个月的平均绝对预测误差为1.00±0.96 D。平均IOL诱导的散光为0.95±0.70 D。此外，术后平均角膜内皮细胞计数（2036±644个细胞/mm）显著低于术前值（2316±527个细胞/mm）（p = 0.009）。没有患者术后1个月时眼压<5 mmHg或>25 mmHg。没有发生术中或威胁视力的并发症，如视网膜脱离、眼内炎或因术后襻错位导致的IOL脱位。
使用hsh-IOL进行巩膜内IOL固定术是囊袋支撑不足的眼睛的一种有效选择。
