Jiang Huaiyan, Fu Wenzhong, Xu Hongxia
The First People's Hospital of Yunnan Province (Kunhua Hospital Affiliated to Kunming University of Science and Technology), Kunming, China.
Stem Cells Int. 2022 Oct 6;2022:3188710. doi: 10.1155/2022/3188710. eCollection 2022.
The purpose of this study was to investigate the effectiveness and practicability of phacoemulsification and intraocular lens implantation for subluxated cataracts. A retrospective review of subluxated cataract surgeries of 19 eyes performed in Kunhua Hospital Affiliated with Kunming University of Science and Technology between January 2017 and June 2021 was conducted. We choose to use the rotate-and-chop phacoemulsification techniques described when the crystal nucleus is rotated out of the capsular bag and simultaneously perform horizontal chops over the capsule. The viscoelastic agent was the important material that filled the capsule to support the capsular bag, and capsular hooks were used in 10 eyes necessarily. Anterior vitrectomy was undergone in 15 eyes. Single-piece intraocular lenses (IOL) were implanted in the capsular bag in 12 eyes including 8 capsular tension ring (CTR) implantation. Three-piece IOLs were fixed scleral layer in 7 eyes. Follow-up was 6 months to 2 years, and all eyes were successfully implanted with centered IOL. The best corrected visual acuity (BCVA) increased from 0.06 ± 0.04 to 0.62 ± 0.15. The cornea of all patients was clear, the intraocular lens was centered, the pupil was round, and the intraocular pressure was normal. Subluxated cataracts are a challenging surgery. The technique of phacoemulsification in subluxated cataract surgery is a key procedure to rotate and remove the lens from the capsule and at the same time horizontal chops and emulsification over the capsular bag to be performed. Viscoelastic agents and capsular hooks were important choices to support the capsule to reduce the incidence of complications related to the vitreous and retina and prevent the range enlarging of the zonular dialysis. A capsular tension ring was also an effective device to maintain capsular stability. Double-needle-guided scleral interlamellar fixation is an effective and practical method for IOL. Overall, the incision technique explored in this study and the surgical technique to support capsular stabilization provide a safe approach and satisfactory results in cataract surgery for subluxation.
本研究的目的是探讨超声乳化白内障吸除联合人工晶状体植入术治疗半脱位白内障的有效性和实用性。对2017年1月至2021年6月在昆明理工大学附属昆华医院进行的19例半脱位白内障手术进行回顾性分析。当晶状体核旋转出囊袋时，我们选择使用所描述的旋转切碎超声乳化技术，并同时在囊膜上进行水平切碎。粘弹剂是填充囊袋以支撑囊膜的重要材料，10只眼必须使用囊膜钩。15只眼进行了前部玻璃体切除术。12只眼在囊袋内植入了单片式人工晶状体（IOL），其中8只眼植入了囊袋张力环（CTR）。有7只眼将三件式IOL固定于巩膜层。随访时间为6个月至2年，所有眼均成功植入居中的IOL。最佳矫正视力（BCVA）从0.06±0.04提高到0.62±0.15。所有患者角膜透明，人工晶状体居中，瞳孔圆形，眼压正常。半脱位白内障手术具有挑战性。半脱位白内障手术中的超声乳化技术是将晶状体从囊袋中旋转并取出，并同时在囊袋上进行水平切碎和乳化的关键步骤。粘弹剂和囊膜钩是支撑囊膜以减少与玻璃体和视网膜相关并发症的发生率并防止晶状体悬韧带离断范围扩大的重要选择。囊袋张力环也是维持囊膜稳定性的有效装置。双针引导巩膜层间固定是一种有效且实用的IOL固定方法。总体而言，本研究探索的切口技术和支持囊膜稳定的手术技术为半脱位白内障手术提供了一种安全的方法和满意的结果。
