Yusef Yu N, Yusef S N, Vvedenskiy A S, Ivanov M N, Alharki L, Fokina N D
Research Institute of Eye Disease, Moscow, Russia.
I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
Vestn Oftalmol. 2022;138(5. Vyp. 2):156-161. doi: 10.17116/oftalma2022138052156.
For the moment, the refractive outcomes of out-of-the-bag intraocular lens (IOL) implantation remain insufficiently studied.
To study and compare the refractive outcomes of retropupillary implantation of an iris-claw lens and transscleral suture fixation of IOL in complicated phacoemulsification.
The study included 70 patients (73 eyes) after complicated phacoemulsification in combination with grade 2 lens subluxation. The first group included 36 patients (39 eyes) who underwent complicated phacoemulsification using torsional ultrasound and retropupillary implantation of an iris-claw lens. The second group included 34 patients (34 eyes) after complicated phacoemulsification using torsional ultrasound and transscleral suture fixation of an elastic hydrophobic IOL. In the postoperative period we performed a comparative evaluation of uncorrected visual acuity and best corrected visual acuity, the average absolute error of IOL optical power calculation, the precision of postoperative refraction within ±0.5 diopters, the degree of induced astigmatism, and the tilt of the IOL.
At three months after surgery uncorrected visual acuity of 0.8-1.0 was achieved in 33.3% of cases in the first group and 17.6% in the second group, the average absolute error of IOL optical power calculation was 0.34±0.08 diopters in the first group and 0.63±0.19 diopters in the second group, the precision of postoperative refraction within ±0.5 diopters was 94.9% in the first group and 85.3% in the second group, the tilt of the IOL was 0.69±0.21° in the first group and 3.19±0.97° in the second group (<0.05). There were no significant differences in best corrected visual acuity and the degree of induced astigmatism 3 months after surgery.
Implantation of an iris-claw lens in the course of complicated phacoemulsification in lens subluxation significantly improves refractive outcomes of the implantation in comparison with transscleral IOL fixation.
目前，囊外人工晶状体（IOL）植入的屈光结果仍研究不足。
研究并比较虹膜爪状晶状体后房植入术和经巩膜缝线固定人工晶状体在复杂性白内障超声乳化术中的屈光结果。
该研究纳入了70例（73只眼）复杂性白内障超声乳化联合2级晶状体半脱位患者。第一组包括36例（39只眼）患者，他们接受了使用扭转超声的复杂性白内障超声乳化术及虹膜爪状晶状体后房植入术。第二组包括34例（34只眼）患者，他们接受了使用扭转超声的复杂性白内障超声乳化术及弹性疏水人工晶状体经巩膜缝线固定术。术后，我们对未矫正视力和最佳矫正视力、人工晶状体屈光力计算的平均绝对误差、术后屈光度在±0.5屈光度范围内的精度、诱导散光程度以及人工晶状体倾斜度进行了比较评估。
术后3个月，第一组33.3%的病例未矫正视力达到0.8 - 1.0，第二组为17.6%；第一组人工晶状体屈光力计算的平均绝对误差为0.34±0.08屈光度，第二组为0.63±0.19屈光度；第一组术后屈光度在±0.5屈光度范围内的精度为94.9%，第二组为85.3%；第一组人工晶状体倾斜度为0.69±0.21°，第二组为3.19±0.97°（<0.05）。术后3个月，最佳矫正视力和诱导散光程度无显著差异。
与经巩膜人工晶状体固定术相比，在晶状体半脱位的复杂性白内障超声乳化术中植入虹膜爪状晶状体可显著改善植入后的屈光结果。
