Alshehri Mohammed, Bin Helayel Halah, Vargas José Manuel, Almutlak Mohammed, Fairaq Rafah
Anterior Segment Division, King Khaled Eye Specialist Hospital, Uruba Road, 11462, Riyadh, Saudi Arabia.
Anterior Segment Division, King Faisal Medical City, Abha, Saudi Arabia.
Int Ophthalmol. 2023 Oct;43(10):3539-3547. doi: 10.1007/s10792-023-02761-8. Epub 2023 Jun 25.
To identify the current surgical management of aphakia and the outcomes and complications of each technique.
This cross-sectional study included ophthalmic surgeons with at least one-year experience in surgery for aphakia. A study questionnaire was formulated to collect data in Saudi Arabia and other regional countries. The questionnaire included 22 questions on demographics, preferred surgical techniques, complications and the factors related to surgeon decision and the choice for managing aphakia.
The study included 145 participants (111; 76.6% were males) with mean age of 46.7 ± 11.5 years. The mean duration of cataract surgery experience was 17.6 ± 11.1 years. Most participants (86.2%) were trained in cataract surgery. Scleral fixation of intraocular lens (SFIOL) was the most commonly preferred technique, followed by iris fixation IOL, and anterior chamber IOL (75.2%, 9%, and 15.9%, respectively). The main determinants for selection of a surgical technique were simplicity (56.6%), surgical instrument availability (48.3%), and training on the technique (47.6%). The most frequent postoperative complications were pupil distortion, high intraocular pressure (IOP), pupillary capture of the IOL, and IOL decentration.
SFIOL is the preferred surgical technique for managing aphakia. The decision to choose one technique over another is complex and is based on several factors, including technical difficulty, previous training, anatomical variations, ocular comorbidities, and the potential complications. The most frequent complications after surgical correction of aphakia are pupil distortion, high IOP, pupillary capture of the IOL, and decentered IOLs.
确定无晶状体眼的当前手术治疗方法以及每种技术的疗效和并发症。
这项横断面研究纳入了至少有一年无晶状体眼手术经验的眼科外科医生。制定了一份研究问卷，以收集沙特阿拉伯和其他地区国家的数据。该问卷包括22个关于人口统计学、首选手术技术、并发症以及与外科医生决策和无晶状体眼治疗选择相关因素的问题。
该研究纳入了145名参与者（111名男性，占76.6%），平均年龄为46.7±11.5岁。白内障手术经验的平均时长为17.6±11.1年。大多数参与者（86.2%）接受过白内障手术培训。人工晶状体巩膜固定术（SFIOL）是最常用的首选技术，其次是虹膜固定人工晶状体，以及前房人工晶状体（分别为75.2%、9%和15.9%）。选择手术技术的主要决定因素是操作简便性（56.6%）、手术器械可用性（48.3%）以及该技术的培训情况（47.6%）。最常见的术后并发症是瞳孔变形、高眼压（IOP）、人工晶状体瞳孔夹持和人工晶状体偏位。
SFIOL是治疗无晶状体眼的首选手术技术。选择一种技术而非另一种技术的决策很复杂，并且基于多种因素，包括技术难度、既往培训、解剖变异、眼部合并症以及潜在并发症。无晶状体眼手术矫正后最常见的并发症是瞳孔变形、高眼压、人工晶状体瞳孔夹持和人工晶状体偏位。
