Boccuzzi Domenico, Purva Date, Orfeo Vincenzo, Napolitano Pasquale, Mularoni Alessandro, Imburgia Aurelio, Forlini Matteo
Ophthalmology Unit "Clinica Mediterranea", Naples, Italy.
Valvekar Medical & Research Centre, Solapur, India.
J Ophthalmol. 2021 Sep 13;2021:9933486. doi: 10.1155/2021/9933486. eCollection 2021.
To evaluate the efficacy and safety of the following three distinct surgical procedures for secondary IOL implantation without capsular support: Iris-claw lens, flanged transscleral fixated IOLs (Yamane technique), and sutureless transscleral hook IOL fixation (Carlevale IOL).
In this retrospective comparative study, three different sutureless IOL implantation techniques were compared in patients without any capsular support. Visual acuity and outcomes were analyzed in 24 eyes of 23 patients (14 male and 9 female). Study included 13 iris-claw lenses (Artisan Ophtec), 6 flanged transscleral fixated IOLs (Yamane technique using a MA60MA Alcon Inc IOL), and 5 transscleral Carlevale IOLS (Carlevale IOL, Soleko, Italy).
logMAR mean best-corrected visual acuity (BCVA) improved from 0.49 ± 0.19 to 0.19 ± 0.10 at three months after surgery ( < 0.05). Postoperative BCVA was similar in all three groups, and no intergroup difference was noted. Three eyes (12.5%) had a raised IOP >25 mmHg, 2 eyes (8%) presented a subluxated/dislocated IOL, 4 eyes (16%) had corneal edema longer than 7 days, 3 eyes (12.5%) had irregular pupil profile, 2 eyes (8%) had vitreous hemorrhage, 7 eyes had (29%) corneal astigmatism over 3 diopters, and one patient (4%) developed cystoid macular edema (CME).
All three surgical procedures can be considered adequate to correct aphakia in patients without capsular support with significant improvement in visual acuity and low complication.
评估以下三种不同的无囊膜支撑二期人工晶状体植入手术方法的疗效和安全性：虹膜爪形人工晶状体、带凸缘的经巩膜固定人工晶状体（山根技术）和无缝合经巩膜钩固定人工晶状体（卡莱瓦尔人工晶状体）。
在这项回顾性比较研究中，对三种不同的无缝合人工晶状体植入技术在无任何囊膜支撑的患者中进行了比较。对23例患者（14例男性和9例女性）的24只眼的视力和手术结果进行了分析。研究包括13枚虹膜爪形人工晶状体（阿蒂桑眼科公司）、6枚带凸缘的经巩膜固定人工晶状体（使用爱尔康公司的MA60MA人工晶状体的山根技术）和5枚经巩膜卡莱瓦尔人工晶状体（卡莱瓦尔人工晶状体，索莱科公司，意大利）。
术后三个月时，logMAR平均最佳矫正视力（BCVA）从0.49±0.19提高到0.19±0.10（P<0.05）。三组术后BCVA相似，未观察到组间差异。3只眼（12.5%）眼压升高>25 mmHg，2只眼（8%）人工晶状体半脱位/脱位，4只眼（16%）角膜水肿持续超过7天，3只眼（12.5%）瞳孔形态不规则，2只眼（8%）玻璃体积血，7只眼（29%）角膜散光超过3屈光度，1例患者（4%）发生黄斑囊样水肿（CME）。
对于无囊膜支撑的患者，所有这三种手术方法都可被认为足以矫正无晶状体状态，视力有显著改善且并发症发生率低。
