Rao G Nageswar, Kumar Sonu, Sinha Nidhi, Rath Bhumika, Pal Arttatrana
Department of Ophthalmology, Kalinga Institute of Medical Science, Kalinga Institute of Industrial Technology, Bhubaneswar, Odisha 751024, India.
Vision Care, Center for Retina, Bhubaneswar, Odisha 751024, India.
Heliyon. 2023 Sep 20;9(9):e20345. doi: 10.1016/j.heliyon.2023.e20345. eCollection 2023 Sep.
To evaluate the surgical visual outcomes of three-piece rigid scleral fixated intraocular lens (SFIOL) implantation in subjects with deficient posterior capsule following complications of cataract extraction.
Retrospective 4-year cohort study.
Data from 174 eyes that underwent SFIOL combined with pars plana vitrectomy (PPV) between January 2018 and March 2022 and follow-up exams were included.
Demographic characteristics including primary indications for surgery, history of trauma, laterality, baseline and best-corrected visual acuity (BCVA), refraction as spherical equivalent (SE), intraocular pressure (IOP), duration of follow-up, and complications were analyzed.
The mean preoperative BCVA was 1.38 ± 0.46 logarithm of the minimum angle of resolution (logMAR), which improved significantly to 0.37 ± 0.22 logMAR. The baseline refractive status measured in spherical equivalent (SE) was 4.1 ± 6.2 Diopters (D), and the postoperative status was -0.4 ± 0.97 D. Early postoperative complications included hypotony (n = 1; 0.57%, vitreous hemorrhage (n = 3; 1.72%), elevated IOP (n = 8; 4.59%), mild dilated pupil (n = 1; 0.57%) and corneal edema (n = 16; 9.19%). Late complications included in this study were retinal detachment (n = 1; 0.57%), cystoid macular edema (CME) (n = 1; 0.57%), primary glaucoma (n = 1; 0.57%), secondary glaucoma (n = 13; 7.47%), zonular dehiscence (n = 3; 1.72%), retinal pigment epithelium (RPE) changes (n = 3; 1.72%), choroidal coloboma (n = 2; 1.14%), posterior dislocation of posterior chamber IOL (PCIOL) (n = 1; 0.57%), corneal decompensation (n = 1; 0.57%), retinal hemorrhage (n = 1; 0.57%), macular hole (n = 1; 0.57%), chronic uveitis (n = 1; 0.57%), mild non-proliferative diabetic retinopathy (NPDR) (n = 3; 1.72%), and mild NPDR with diabetic macular edema (DME) (n = 1; 0.57%).
Integrating IOL implantation with vitrectomy various posterior segment complications were resolved in the same setting without attempting a second surgery.
评估三件式硬性巩膜固定人工晶状体（SFIOL）植入术在白内障摘除术后并发后囊膜缺损患者中的手术视觉效果。
回顾性4年队列研究。
纳入了2018年1月至2022年3月期间接受SFIOL联合玻璃体切除术（PPV）并进行随访检查的174只眼的数据。
分析人口统计学特征，包括手术主要指征、外伤史、眼别、基线及最佳矫正视力（BCVA）、等效球镜度（SE）屈光状态、眼压（IOP）、随访时间及并发症。
术前平均BCVA为1.38±0.46最小分辨角对数（logMAR），显著改善至0.37±0.22 logMAR。基线等效球镜度（SE）屈光状态为4.1±6.2屈光度（D），术后为-0.4±0.97 D。术后早期并发症包括低眼压（n = 1；0.57%）、玻璃体出血（n = 3；1.72%）、眼压升高（n = 8；4.59%）、瞳孔轻度散大（n = 1；0.57%）和角膜水肿（n = 16；9.19%）。本研究中的晚期并发症包括视网膜脱离（n = 1；0.57%）、黄斑囊样水肿（CME）（n = 1；0.57%）、原发性青光眼（n = 1；0.57%）、继发性青光眼（n = 13；7.47%）、悬韧带断裂（n = 3；1.72%）、视网膜色素上皮（RPE）改变（n = 3；1.72%）、脉络膜缺损（n = 2；1.14%）、后房型人工晶状体（PCIOL）后脱位（n = 1；0.57%）、角膜失代偿（n = 1；0.57%）、视网膜出血（n = 1；0.57%）、黄斑裂孔（n = 1；0.57%）慢性葡萄膜炎（n = 1；0.57%）、轻度非增殖性糖尿病视网膜病变（NPDR）（n = 3；1.72%）以及合并糖尿病性黄斑水肿（DME）的轻度NPDR（n = 1；0.57%）。
将人工晶状体植入与玻璃体切除术相结合，可在同一手术中解决各种后段并发症，无需进行二次手术。
