Ucar Fikret
Ophthalmology Department, 590009Konyagoz Eye Hospital, Konya, Turkey.
Eur J Ophthalmol. 2023 Jan;33(1):615-620. doi: 10.1177/11206721221125016. Epub 2022 Sep 8.
To describe the facilitated trailing haptic externalization technique for intrascleral intraocular lens (IOL) fixation.
In this technique, first the direction of the 4-5 mm tip of the trailing haptic is straightened with the help of forceps. After the second needle enters the posterior chamber, the edge of the IOL optic is pushed towards the opposite scleral tunnel with the needle. The trailing haptic approaching the center from the periphery and the straightened distal part of the haptic towards the direction of the needle facilitate the relatively easily and gently placing of the haptic into the lumen with a one-time use of forceps.
This technique was performed on 65 eyes of 58 patients, with a mean patient age of 53.0 ± 14.6 years (range, 22-78). No complications such as endothelial touch, vitreous loss, iris or ciliary body damage, and hyphema were encountered during surgery. The mean operation duration was 14.8 ± 2.3 min (range, 12-20). In the postoperative period, there was only mild postoperative anterior chamber reaction in all eyes. Postoperative transient intraocular pressure (IOP) elevation that responded well to topical antiglucomatous therapy was observed in only two cases (3%). No patient developed haptic exposure, IOL dislocation, iris capture, postoperative hypotony, vitreous hemorrhage, choroidal effusion, cystoid macular edema, or retinal detachment.
The facilitated trailing haptic externalization technique provides a safer, simpler, and minimally invasive surgery without significant complications while easing the surgical difficulties of the Yamane technique.
描述用于巩膜内人工晶状体(IOL)固定的辅助后襻触觉外置技术。
在该技术中,首先用镊子将后襻4-5毫米尖端的方向拉直。在第二根针进入后房后,用针将IOL光学部的边缘推向相对的巩膜隧道。后襻从周边向中心靠近,且襻的伸直远端朝针的方向,这有助于用一次镊子操作就能相对轻松、轻柔地将襻放入管腔。
该技术应用于58例患者的65只眼中,患者平均年龄为53.0±14.6岁(范围22-78岁)。手术过程中未遇到诸如内皮接触、玻璃体丢失、虹膜或睫状体损伤以及前房积血等并发症。平均手术时间为14.8±2.3分钟(范围12-20分钟)。术后,所有眼仅出现轻度的术后前房反应。仅2例(3%)观察到术后短暂眼压(IOP)升高,对局部抗青光眼治疗反应良好。没有患者发生襻暴露、IOL脱位、虹膜夹持、术后低眼压、玻璃体出血、脉络膜渗漏、黄斑囊样水肿或视网膜脱离。
辅助后襻触觉外置技术提供了一种更安全、更简单且微创的手术,无明显并发症,同时缓解了Yamane技术的手术难度。