Department of Ophthalmology & Vision Science, University of Arizona College of Medicine, Tucson, Arizona.
Funding from University of Arizona Graduate Medical Education Resident & Fellow Research Scholarship 2022 to 2023, University of Arizona College of Medicine-Tucson, Tucson, Arizona; and.
Retina. 2024 Feb 1;44(2):280-287. doi: 10.1097/IAE.0000000000003950.
Report and compare long-term outcomes and complications of sutureless scleral tunnel (SST) and flanged haptic (FH) scleral-fixated intraocular lens, with spontaneous intraocular lens (IOL) dislocation as primary outcome measure.
Retrospective single-surgeon case series of 95 SST and 458 FH eyes from 2011 to 2022 (553 total eyes). Demographics, surgical indications, ocular history, visual acuity, and complication rates were collected.
Reoperation-requiring spontaneous IOL dislocation rate was significantly different ( P = 0.0167) between FH (3.7%) and SST (10.5%). Mean follow-up was 3.31 ± 0.30 versus 1.58 ± 0.07 years for SST and FH, respectively. There was no significant difference between preoperative (20/305 vs. 20/300) or final postoperative (20/77 vs. 20/62) visual acuity. Other complications included any cystoid macular edema (20.0% vs. 25.3%), elevated intraocular pressure (16.8% vs. 9.6%), IOL tilt requiring reoperation (5.3 vs. 0%), haptic exposure (2.1% vs. 3.3%), and reverse pupillary block (4.2% vs. 1.1%).
Haptic flanging resulted in fewer eyes meeting the primary end point of IOL dislocation. We reported the longest-to-date follow-up of both nonflanged SST IOL fixation and our FH-modified Yamane technique. Our FH-modified Yamane technique represents a safe, durable, and potentially superior option for scleral-fixated intraocular lens.
报告并比较无缝线巩膜隧道（SST）和带翼压接式巩膜固定人工晶状体的长期结果和并发症，以自发性人工晶状体（IOL）脱位为主要观察终点。
回顾性分析 2011 年至 2022 年期间，由同一位外科医生完成的 95 例 SST 和 458 例 FH 眼（共 553 只眼）的病例系列研究。收集了人口统计学资料、手术适应证、眼部病史、视力和并发症发生率等数据。
FH 组（3.7%）和 SST 组（10.5%）的自发性 IOL 脱位再手术率差异有统计学意义（P = 0.0167）。SST 组和 FH 组的平均随访时间分别为 3.31 ± 0.30 年和 1.58 ± 0.07 年。术前（20/305 与 20/300）和最终术后（20/77 与 20/62）视力均无显著差异。其他并发症包括任何类型的黄斑囊样水肿（20.0%与 25.3%）、高眼压（16.8%与 9.6%）、需要再次手术矫正的 IOL 倾斜（5.3%与 0%）、人工晶状体襻暴露（2.1%与 3.3%）和后发性瞳孔阻滞（4.2%与 1.1%）。
带翼压接式巩膜固定人工晶状体的术后 IOL 脱位发生率更低。我们报告了最长时间的非带翼 SST IOL 固定和我们的 FH 改良 Yamane 技术的随访结果。我们的 FH 改良 Yamane 技术是一种安全、持久且可能更优越的巩膜固定人工晶状体技术。
