Department of Ophthalmology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Republic of Korea.
Metro Eye Clinic, Republic of Korea; and.
Retina. 2023 Jun 1;43(6):964-971. doi: 10.1097/IAE.0000000000003743.
To identify risk factors for pupillary optic capture after sutureless flanged intraocular lens (IOL) fixation for IOL dislocation.
This retrospective comparative study enrolled consecutive patients who underwent flanged IOL fixation using 25-gauge pars plana vitrectomy. One hundred twenty-six eyes (126 patients) were divided into two groups according to the presence or absence of pupillary optic capture. A swept-source anterior segment optical coherence tomography and a rotating Scheimpflug camera were used to analyze and compare surgical parameters, including axial length, anterior chamber depth, differences in scleral tunnel angle and length, and IOL tilt and decentration, between the two groups.
Compared with the nonpupillary optic capture group (106 eyes, 84.1%), the pupillary optic capture group (20 eyes, 15.9%) had larger differences in the nasal and temporal scleral tunnel angles and larger horizontal tilt (P < 0.05). Multivariate regression analysis demonstrated that these factors correlated with the occurrence of pupillary optic capture (P < 0.05).
To prevent pupillary optic capture after flanged IOL fixation, surgeons should avoid asymmetry in the angles of the nasal and temporal scleral tunnels, which causes horizontal IOL tilt and subsequent pupillary capture.
确定无巩膜缝线边缘型人工晶状体(IOL)固定治疗 IOL 脱位后瞳孔光学捕获的危险因素。
这是一项回顾性对比研究,纳入了连续接受 25G 经睫状体平坦部玻璃体切除术进行边缘型 IOL 固定的患者。根据是否存在瞳孔光学捕获,将 126 只眼(126 例患者)分为两组。使用扫频源眼前节光学相干断层扫描和旋转式 Scheimpflug 相机分析和比较两组之间的手术参数,包括眼轴长度、前房深度、巩膜隧道角度和长度的差异以及 IOL 倾斜和偏心。
与非瞳孔光学捕获组(106 只眼,84.1%)相比,瞳孔光学捕获组(20 只眼,15.9%)的鼻侧和颞侧巩膜隧道角度差异更大,水平倾斜更大(P < 0.05)。多变量回归分析表明,这些因素与瞳孔光学捕获的发生相关(P < 0.05)。
为了防止边缘型 IOL 固定后瞳孔光学捕获,外科医生应避免鼻侧和颞侧巩膜隧道角度的不对称,这会导致 IOL 水平倾斜和随后的瞳孔捕获。