Eye Institute, Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China.
NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China.
BMC Ophthalmol. 2023 Jun 13;23(1):271. doi: 10.1186/s12886-023-03020-1.
To compare the outcomes of sutured transscleral fixation and sutureless intrascleral fixation for the treatment of a dislocated intraocular lens (IOL).
Thirty-five eyes of 35 patients who required IOL repositioning surgery due to IOL dislocation were included in this retrospective study. Sixteen eyes underwent two-point sutured transscleral fixation, eight eyes underwent one-point sutured transscleral fixation, and 11 eyes underwent sutureless intrascleral IOL fixation. The patients were followed for ≥ 12 months after repositioning surgery, and their postoperative outcomes were recorded and analyzed.
The major cause of IOL dislocation was ocular blunt trauma (19/35, 54.3%). The mean corrected distance visual acuity (CDVA) improved significantly after IOL repositioning (P = 0.022). The mean postoperative change in endothelial cell density (ECD) was - 4.5%. There were no significant differences in the changes in CDVA or ECD among the three groups with different repositioning techniques (both P > 0.1). The mean vertical tilt of the IOLs in all enrolled patients was significantly greater than the horizontal value (P = 0.001). The vertical tilt was greater in the two-point scleral fixation group than that in the sutureless intrascleral fixation group (P = 0.048). The mean decentration values in the one-point scleral fixation group in the horizontal and vertical directions were greater than those in the other two groups (all P < 0.01).
All three IOL repositioning techniques resulted in favorable ocular prognosis.
比较缝线经巩膜固定与无缝线巩膜内固定治疗晶状体脱位的效果。
本回顾性研究纳入 35 例（35 只眼）因晶状体脱位而需行晶状体重新定位手术的患者。16 只眼行两点式缝线经巩膜固定，8 只眼行一点式缝线经巩膜固定，11 只眼行无缝线巩膜内晶状体固定。患者在晶状体重新定位手术后随访时间均≥12 个月，记录并分析其术后结果。
晶状体脱位的主要原因为眼钝挫伤（19/35，54.3%）。晶状体重新定位后，患者的平均矫正远距视力（CDVA）显著提高（P=0.022）。平均术后内皮细胞密度（ECD）下降 4.5%。三种不同复位技术组间的 CDVA 或 ECD 变化差异均无统计学意义（均 P>0.1）。所有纳入患者的晶状体垂直倾斜度明显大于水平值（P=0.001）。两点式巩膜固定组的晶状体垂直倾斜度大于无缝线巩膜内固定组（P=0.048）。一点式巩膜固定组在水平和垂直方向的平均偏心值均大于其他两组（均 P<0.01）。
三种晶状体重新定位技术均有良好的眼部预后。
