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一种用于卡尔维勒人工晶状体植入的微创手术技术:病例系列研究及同期手术描述

A mini-invasive surgical technique for Carlevale IOL implantation: case series study and description of concomitant surgery.

作者信息

Danese Carla, Di Bin Francesco, Lanzetta Paolo

机构信息

Department of Medicine - Ophthalmology, University of Udine, Udine, Italy.

Ophthalmology Department, AP-HP, Lariboisière Hospital, Université Paris Cité, Paris, France.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2024 Feb;262(2):487-494. doi: 10.1007/s00417-023-06217-8. Epub 2023 Aug 30.

Abstract

PURPOSE

To examine the feasibility and outcomes of a modified technique for the implantation of scleral fixated Carlevale intraocular lens (IOL) (I71 FIL SSF. Soleko IOL Division, Pontecorvo, Italy), and to analyze the occurrence of adverse events.

METHODS

This is a retrospective observational study conducted revising patients charts from 2018 to 2023. Thirty-five eyes of 33 patients were included. Patients requiring IOL explantation had either IOL dislocation or opacification. The implantation of the Carlevale IOL was performed with the subconjunctival positioning of the anchors without any scleral flap. All maneuvers were performed transconjunctivally. The anatomical outcomes considered were IOL positioning, and the absence of postoperative complications. The functional outcomes analyzed were best correctedvisual acuity (BCVA) and refraction.

RESULTS

In all the cases, the IOL was well positioned and centered postoperatively. No cases of conjunctival erosion were recorded. The best corrected visual acuity (BCVA) was 0.9±0.6 logMar (mean±standard deviation) preoperatively and 0.5±0.5 logMar (mean±standard deviation) postoperatively. The mean preoperative spherical equivalent was +6.8±7.7 dioptres, while postoperatively it was -1.1±1.6 dioptres. The most frequent procedure associated to secondary IOL implantation was posterior vitrectomy (25 eyes, 71.4%), which was performed with 25-gauge transconjunctival cannulas in the ciliary sulcus. The follow-up period was 24.5±16.9 months (mean±standard deviation).

CONCLUSION

The described mini-invasive technique for Carlevale IOL implantation is safe and effective. It can be recommended either as a stand-alone operation or associated to concurrent surgical procedures.

摘要

目的

探讨改良技术植入巩膜固定型卡尔维勒人工晶状体(IOL)(I71 FIL SSF。索莱科IOL部门,意大利蓬泰科尔沃)的可行性和效果,并分析不良事件的发生情况。

方法

这是一项回顾性观察研究,对2018年至2023年患者病历进行回顾。纳入33例患者的35只眼。需要取出人工晶状体的患者存在人工晶状体脱位或混浊。卡尔维勒人工晶状体的植入是通过结膜下定位固定器进行的,无需制作巩膜瓣。所有操作均经结膜进行。观察的解剖学结果为人工晶状体定位以及无术后并发症。分析的功能结果为最佳矫正视力(BCVA)和屈光状态。

结果

所有病例中,人工晶状体术后均定位良好且居中。未记录到结膜糜烂病例。术前最佳矫正视力(BCVA)为0.9±0.6 logMar(平均值±标准差),术后为0.5±0.5 logMar(平均值±标准差)。术前平均等效球镜度为+6.8±7.7屈光度,术后为-1.1±1.6屈光度。与二期人工晶状体植入相关的最常见手术是玻璃体后脱离(25只眼,71.4%),通过25G经结膜套管在睫状沟进行。随访期为24.5±16.9个月(平均值±标准差)。

结论

所描述的卡尔维勒人工晶状体植入微创技术安全有效。可推荐作为独立手术或与同期手术联合使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a9a9/10844417/4304a4662e30/417_2023_6217_Fig1_HTML.jpg

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