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经巩膜缝线固定于睫状沟内的人工晶状体的长期效果。

Long-term outcomes of transsclerally sutured intraocular lens correctly fixed in the ciliary sulcus.

机构信息

Sugiura Eye Clinic, Fuji, Shizuoka, Japan

Sugiura Eye Clinic, Fuji-shi, Tokyo, Japan.

出版信息

BMJ Open Ophthalmol. 2022 Apr;7(1). doi: 10.1136/bmjophth-2021-000935.

Abstract

OBJECTIVE

To report the long-term postoperative outcomes of transsclerally sutured intraocular lenses (IOLs), in which the haptics were correctly fixated into the ciliary sulcus using an auxiliary device and endoscope.

METHODS AND ANALYSIS

Data were collected from eyes that were followed up for at least 12 months after ciliary sulcus suture fixation of an IOL using an auxiliary device for securely placing the IOL haptics to the ciliary sulcus, which was confirmed using intraoperative endoscopy in all cases. The corrected distance visual acuity (CDVA), refractive error, anterior chamber depth (ACD), IOL decentration and tilt, corneal endothelial cell density (CECD) and postoperative complications were recorded. ACD and IOL deviations were compared with those of normal controls after standard cataract surgery.

RESULTS

A total of 146 eyes of 142 patients were included, with a mean follow-up period of 56.0±35.3 (range 12-174) months. Postoperative CDVA from 1 month to 8 years and final CDVA were significantly better, and the mean refraction error, ACD and CECD decline rate were -0.71±0.75 dioptre, 4.01±0.37 mm and -7.4%±16.0%, respectively. Compared with normal controls, ACD was not significantly different but the tilt and decentration were significantly different. The main postoperative complications included vitreous haemorrhage (24.0%), suture thread exposure (19.2%) and corectopia (18.5%). There were no cases of IOL dislocation due to suture breakage or postoperative endophthalmitis CONCLUSION: Long-term postoperative outcomes were favorable with good CDVA and without IOL dislocation and endophthalmitis. The significance and value of fixing haptics to the ciliary sulcus should be re-evaluated.

摘要

目的

报告使用辅助器械和内窥镜将巩膜缝线固定的人工晶状体(IOL)的长期术后结果,在此过程中,晶状体襻被正确固定在睫状沟内。

方法和分析

收集了至少随访 12 个月的患者的眼部数据,这些患者使用辅助器械将 IOL 安全地固定在睫状沟中,在所有病例中均通过术中内窥镜进行确认。记录矫正远视力(CDVA)、屈光不正、前房深度(ACD)、IOL 偏心和倾斜、角膜内皮细胞密度(CECD)和术后并发症。将 ACD 和 IOL 偏差与标准白内障手术后的正常对照组进行比较。

结果

共纳入 142 例 146 只眼,平均随访时间为 56.0±35.3(范围 12-174)个月。术后 1 个月至 8 年的 CDVA 和最终 CDVA显著提高,平均屈光不正、ACD 和 CECD 下降率分别为-0.71±0.75 屈光度、4.01±0.37 毫米和-7.4%±16.0%。与正常对照组相比,ACD 无显著差异,但倾斜和偏心差异显著。主要术后并发症包括玻璃体积血(24.0%)、缝线外露(19.2%)和核异位(18.5%)。没有因缝线断裂或术后眼内炎导致 IOL 脱位的病例。

结论

长期术后结果良好,具有良好的 CDVA,且无 IOL 脱位和眼内炎。固定襻至睫状沟的意义和价值应重新评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67c1/9058782/7454bb642c73/bmjophth-2021-000935f01.jpg

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