Durmus Ebubekir, Aykut Veysel, Hepokur Mustafa, Sali Fatma, Sanisoglu Huseyin Avni, Oguz Halit, Esen Fehim
Department of Ophthalmology, Istanbul Medeniyet University, İstanbul, Türkiye.
Department of Ophthalmology, Goztepe Prof. Dr. Suleyman Yalçin City Hospital, İstanbul, Türkiye.
Beyoglu Eye J. 2023 Dec 1;8(4):253-259. doi: 10.14744/bej.2023.30085. eCollection 2023.
Iris-claw intraocular lens (IC-IOL) implantation and sutureless scleral fixation of intraocular lenses (SSF-IOL) are two commonly preferred surgical approaches for the management of aphakic patients without sufficient capsular support. The aim of this study was to compare the outcomes of IC-IOL implantation and trocar-assisted SSF-IOL implantation.
The medical records of secondary IOL implantation patients were retrospectively reviewed. All patients had a detailed ophthalmological examination, including LogMAR best-corrected distance visual acuity (CDVA), intraocular pressure (IOP), and endothelial cell density (ECD) preoperatively and postoperatively. SPSS 21.0 software was used for the statistical analysis.
There were 15 patients in the IC-IOL group and 12 patients in the SSF-IOL group. Age and gender distributions were similar between the groups (p=0.456 and p=0.398, respectively). Similarly, patients in both groups had similar CDVA preoperatively and postoperatively (p=0.51, p=0.48, respectively). Both IC-IOL and SSF-IOL implantation significantly increased CDVA (p=0.001 and p=0.005, respectively). IOP remained unchanged in both groups. However, ECD reduced significantly following both IC-IOL and SSF-IOL implantation (p=0.001 and p=0.005, respectively) and trocar-assisted SSF-IOL implantation resulted in significantly more endothelial loss compared to IC-IOL implantation (439.5±89 vs. 164.4±53, p=0.013).
Both surgical approaches increased CDVA significantly and at similar levels. However, trocar-assisted SSF-IOL implantation resulted in significantly more endothelial loss compared to IC-IOL implantation. None of the patients developed bullous keratopathy, but this difference should be kept in mind, especially in patients with critically low ECD.
虹膜爪型人工晶状体（IC-IOL）植入术和无缝线巩膜固定人工晶状体（SSF-IOL）植入术是治疗无足够囊袋支撑的无晶状体患者的两种常用手术方法。本研究的目的是比较IC-IOL植入术和套管针辅助SSF-IOL植入术的效果。
对二期人工晶状体植入患者的病历进行回顾性分析。所有患者术前和术后均进行了详细的眼科检查，包括LogMAR最佳矫正远视力（CDVA）、眼压（IOP）和内皮细胞密度（ECD）。使用SPSS 21.0软件进行统计分析。
IC-IOL组有15例患者，SSF-IOL组有12例患者。两组间年龄和性别分布相似（分别为p = 0.456和p = 0.398）。同样，两组患者术前和术后的CDVA相似（分别为p = 0.51，p = 0.48）。IC-IOL和SSF-IOL植入均显著提高了CDVA（分别为p = 0.001和p = 0.005）。两组眼压均保持不变。然而，IC-IOL和SSF-IOL植入后ECD均显著降低（分别为p = 0.001和p = 0.005），与IC-IOL植入相比，套管针辅助SSF-IOL植入导致的内皮细胞损失明显更多（439.5±89 vs. 164.4±53，p = 0.013）。
两种手术方法均显著提高了CDVA，且水平相似。然而，与IC-IOL植入相比，套管针辅助SSF-IOL植入导致的内皮细胞损失明显更多。所有患者均未发生大疱性角膜病变，但应牢记这一差异，尤其是在ECD极低的患者中。
