Department of Ophthalmology, Korea University Ansan Hospital, Ansan, Korea.
Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea.
Korean J Ophthalmol. 2023 Apr;37(2):128-136. doi: 10.3341/kjo.2022.0093. Epub 2023 Feb 9.
To compare the clinical outcomes of intrascleral fixation of the three-piece intraocular lenses (IOLs) 2.5 mm posterior to the limbus with ciliary sulcus implantation and transscleral fixation 2.5 mm posterior to the limbus.
Sixty-five eyes of 65 patients who underwent ciliary sulcus implantation or transscleral or intrascleral fixation of the AMO Sensar AR40e IOL were retrospectively reviewed. The postoperative refractive prediction error, back-calculated effective lens position (ELP), corrected distance visual acuity (CDVA), and postoperative residual cylinder were compared.
There were significant differences in the median (interquartile range) postoperative refractive prediction error (diopters [D]) among the three groups (p < 0.001): for ciliary sulcus implantation (33 eyes), -0.89 D (-1.21 to -0.56 D); for transscleral fixation (10 eyes), -0.40 D (-0.78 to -0.22 D); and for intrascleral fixation (22 eyes), 0.01 D (-0.28 to 0.34 D). Significant differences (p < 0.001) were observed in the median back-calculated ELP: for ciliary sulcus implantation, 4.35 mm (3.95 to 4.55 mm); for transscleral fixation, 4.51 mm (4.34 to 4.76 mm); and for intrascleral fixation, 4.90 mm (4.56 to 5.35 mm). There were no differences in the median postoperative CDVA (0, 0.10, and 0 logarithm of the minimum angle of resolution, respectively; p = 0.083) and the residual cylinder (-0.75, -1.50, and -0.63 D, respectively; p = 0.074) among three groups.
Intrascleral fixation showed no myopic shift and the most posterior lens position, while ciliary sulcus implantation induced the greatest myopic shift and the most anterior lens position. However, there was no significant difference in the postoperative CDVA or astigmatism among the eyes with different IOL insertion methods, demonstrating good IOL stability and vision outcomes.
比较巩膜内固定三片式人工晶状体（IOL）在睫状沟后 2.5mm 与巩膜后 2.5mm 处的睫状沟植入和经巩膜固定的临床效果。
回顾性分析 65 例（65 只眼）接受睫状沟植入或经巩膜或巩膜内固定 AMO Sensar AR40e IOL 的患者资料。比较三组术后屈光度预测误差、反向计算的有效晶状体位置（ELP）、矫正远视力（CDVA）和术后残余散光。
三组术后屈光度预测误差（中位数[四分位间距]，D）差异有统计学意义（p<0.001）：睫状沟植入组（33 只眼）为-0.89D（-1.21 至-0.56D）；经巩膜固定组（10 只眼）为-0.40D（-0.78 至-0.22D）；巩膜内固定组（22 只眼）为 0.01D（-0.28 至 0.34D）。反向计算的 ELP 中位数差异有统计学意义（p<0.001）：睫状沟植入组为 4.35mm（3.95 至 4.55mm）；经巩膜固定组为 4.51mm（4.34 至 4.76mm）；巩膜内固定组为 4.90mm（4.56 至 5.35mm）。三组术后 CDVA 中位数（0、0.10 和 0 最小分辨角对数，分别；p=0.083）和残余散光中位数（-0.75、-1.50 和-0.63D，分别；p=0.074）差异均无统计学意义。
巩膜内固定无近视漂移，晶状体位置最靠后；而睫状沟植入导致最大的近视漂移和最靠前的晶状体位置。然而，不同 IOL 植入方法的眼之间，术后 CDVA 或散光差异无统计学意义，表明 IOL 稳定性和视力结果良好。
