Oli Avadhesh, Yadav Anil, Babu J Ganesh, Balakrishnan Divya
L V Prasad Eye Institute, Hyderabad, India.
L V Prasad Eye Institute, Kallam Anji Reddy Campus, L. V. Prasad Marg, Banjara Hills, Hyderabad 500034, Telangana, India.
Ther Adv Ophthalmol. 2023 Jan 12;15:25158414221147208. doi: 10.1177/25158414221147208. eCollection 2023 Jan-Dec.
Scleral fixation of intraocular lens (IOLs) is the most preferred technique for the management of aphakia and the techniques have evolved over the years. These methods have their advantages and disadvantages, however, the major concern being the position of the intraocular lens, its stability and complications. The final IOL position is the major determinant of the final visual acuity, and various imaging modalities have been used to quantify the IOL tilt.
Use of Scheimpflug imaging to evaluate the IOL tilt in modified flanged scleral-fixated intraocular lens (MFSIOL).
Retrospective chart review of 41 consecutive patients who underwent MFIOL.
We conducted a retrospective chart review of 41 consecutive patients who underwent MFIOL. The baseline and final best-corrected visual acuity (BCVA), refractive error, and clinical examination findings were recorded. The vertical and horizontal tilts of the IOLs were calculated using the Scheimpflug image. The IOL tilt (in degrees) in the vertical and horizontal axes was the primary outcome and the BCVA, residual refractive error, intraocular pressure, and surgical complications were secondary outcome measures.
The mean baseline BCVA was logMAR 0.49, which improved to logMAR 0.356 ( < .005) after the surgery. The mean IOL tilt in the vertical axis was 3.40° (range of 0.0°-8.5°, interquartile range: 1.21-5.66) and in the horizontal axis was 1.35° (range of 0.60°-4.620°, interquartile range: 0.44-1.86), respectively. There was no correlation between angle of IOL tilt and UCVA ( = 0.089, = 0.580), BCVA ( = 0.109, = 0.498), final spherical error ( = 0.081, = 0.615), cylindrical error ( = 0.207, = 0.195), axial length ( = 0.105, = 0.514), and IOL power ( = -0.139, = 0.388).
Modified flanged IOL (MFIOL) is an alternative technique for intrascleral fixation of IOL resulting in good lens stability. The IOL tilt achieved by this technique is minimal and did not influence the final visual outcome or spectacle correction. Scheimpflug imaging is simple and non-invasive method to measure the IOL tilt.
This study on 41 eyes was aimed to analyze the lens tilt using Scheimpflug imaging in cases of modified flanged scleral fixation of intraocular lens (MFSFIOL), which is a novel technique to minimize the complications and simplify the procedure. The intraocular lens (IOL) remained stable with an acceptable range of vertical and horizontal tilt. There was no significant effect of IOL tilt on the final best-corrected visual acuity (BCVA) or spectacle correction. Scheimpflug imaging is an accurate and non-invasive technique for assessment of lens position in the patients with intrascleral fixation of IOL.
人工晶状体（IOL）的巩膜固定术是治疗无晶状体眼最常用的技术，多年来该技术不断发展。这些方法各有优缺点，然而，主要关注点在于人工晶状体的位置、稳定性及并发症。最终的人工晶状体位置是最终视力的主要决定因素，已使用多种成像方式来量化人工晶状体倾斜度。
使用Scheimpflug成像评估改良带凸缘巩膜固定人工晶状体（MFSIOL）的人工晶状体倾斜度。
对41例接受MFIOL手术的连续患者进行回顾性病历审查。
我们对41例接受MFIOL手术的连续患者进行了回顾性病历审查。记录基线和最终最佳矫正视力（BCVA）、屈光不正及临床检查结果。使用Scheimpflug图像计算人工晶状体的垂直和水平倾斜度。垂直和水平轴上的人工晶状体倾斜度（以度为单位）是主要结局指标，BCVA、残余屈光不正、眼压及手术并发症是次要结局指标。
平均基线BCVA为logMAR 0.49，术后改善至logMAR 0.356（P＜0.005）。人工晶状体垂直轴平均倾斜度为3.40°（范围0.0° - 8.5°，四分位间距：1.21 - 5.66），水平轴平均倾斜度为1.35°（范围0.60° - 4.620°，四分位间距：0.44 - 1.86）。人工晶状体倾斜角度与未矫正视力（r = 0.089，P = 0.580）、BCVA（r = 0.109，P = 0.498）、最终球镜度数（r = 0.081，P = 0.615）、柱镜度数（r = 0.207，P = 0.195）、眼轴长度（r = 0.105，P = 0.514）及人工晶状体度数（r = -0.139，P = 0.388）之间均无相关性。
改良带凸缘人工晶状体（MFIOL）是人工晶状体巩膜内固定的一种替代技术，可实现良好的晶状体稳定性。该技术实现的人工晶状体倾斜度最小，且不影响最终视觉效果或眼镜矫正。Scheimpflug成像是测量人工晶状体倾斜度的简单且非侵入性方法。
Scheimpflug成像用于改良带凸缘巩膜固定人工晶状体位置：本研究对41只眼进行分析，旨在利用Scheimpflug成像评估改良带凸缘巩膜固定人工晶状体（MFSFIOL）病例中的晶状体倾斜度，这是一种可减少并发症并简化手术过程的新技术。人工晶状体保持稳定，垂直和水平倾斜度在可接受范围内。人工晶状体倾斜度对最终最佳矫正视力（BCVA）或眼镜矫正无显著影响。Scheimpflug成像是评估人工晶状体巩膜内固定患者晶状体位置的准确且非侵入性技术。
