Medical University of South Carolina, Charleston, South Carolina.
Medical University of South Carolina, Charleston, South Carolina.
J AAPOS. 2022 Aug;26(4):171.e1-171.e6. doi: 10.1016/j.jaapos.2022.03.009. Epub 2022 Jul 8.
To report long-term outcomes of iris claw aphakia intraocular lens (IOL) implantation for nontraumatic ectopia lentis (EL) in children.
In this prospective study, children who underwent Artisan Aphakia IOL placement were included if they have a minimum of 1-year follow-up after implantation. Main outcome measures were: best-corrected distance visual acuity, reoperations, change in central corneal thickness (CCT), and corneal endothelial cell counts (ECC).
The Artisan Aphakia IOL was implanted in a total of 76 eyes of 43 patients (68 eyes of 34 patients with EL). 56 eyes of 28 patients have been followed long enough to meet the inclusion criteria for this report. The average age at Artisan Aphakia IOL implantation was 11.1 years (range of 2-20 years). Average follow-up was 3.59 years, and 23% of patients have >5 years' follow-up. Mean best-corrected visual acuity improved from 0.36 (20/46) to logMAR 0.18 (20/30) after implantation (P = 0.02). Five reoperations were needed in 4 patients, 3 (7%) related to post-implantation trauma. Average preoperative CCT was 580 μm; estimated mean increase in CCT at the 5-year postoperative visit was 11.9 μm higher (P = 0.047). Average preoperative ECC was 3178 cells/mm; estimated mean loss of ECC at the 5-year postoperative visit was not significantly different from zero (187.7 cells/mm [P = 0.102]).
The Artisan Aphakia IOL, used in the absence of capsular support, had an acceptable safety profile in our patients.
报告非外伤性晶状体异位（EL）患儿虹膜夹型无晶状体眼人工晶状体（IOL）植入的长期结果。
在这项前瞻性研究中，纳入了植入后至少随访 1 年的接受 Artisan Aphakia IOL 植入术的患儿。主要观察指标为：最佳矫正远视力、再手术、中央角膜厚度（CCT）变化和角膜内皮细胞计数（ECC）。
共有 43 例患者（34 例 EL 患者 68 只眼）的 76 只眼植入了 Artisan Aphakia IOL。28 例患者中的 56 只眼随访时间足够长，符合本报告的纳入标准。Artisan Aphakia IOL 植入的平均年龄为 11.1 岁（2-20 岁）。平均随访时间为 3.59 年，23%的患者随访时间>5 年。植入后平均最佳矫正视力从 0.36（20/46）提高至 logMAR 0.18（20/30）（P=0.02）。4 例患者中有 5 例需要再次手术，其中 3 例（7%）与植入后创伤有关。术前 CCT 平均为 580μm；术后 5 年 CCT 估计平均增加 11.9μm（P=0.047）。术前 ECC 平均为 3178 个细胞/mm；术后 5 年 ECC 估计平均损失与零无显著差异（187.7 个细胞/mm[P=0.102]）。
在缺乏囊袋支持的情况下，Artisan Aphakia IOL 在我们的患者中具有可接受的安全性。
