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无缝巩膜内眼晶状体固定术和改良虹膜环扎瞳孔成形术治疗无晶状体眼和外伤性散瞳。

Sutureless intrascleral intraocular lens fixation and modified iris cerclage pupilloplasty for aphakia and traumatic mydriasis.

机构信息

Department of Ophthalmology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China.

Department of Ophthalmology, Dalian Medical University, Dalian, Liaoning Province, China.

出版信息

Indian J Ophthalmol. 2024 Feb 1;72(Suppl 2):S224-S228. doi: 10.4103/IJO.IJO_1090_23. Epub 2024 Jan 25.

Abstract

PURPOSE

To evaluate the safety and efficacy of sutureless intrascleral intraocular lens (IOL) fixation combined with modified iris cerclage pupilloplasty for treating aphakia and traumatic mydriasis.

METHODS

Five patients with aphakia and traumatic mydriasis were operated on by the same surgeon. All patients underwent sutureless intrascleral IOL fixation combined with modified iris cerclage pupilloplasty and were followed up for ≥6 months. Best-corrected visual acuity (BCVA) was measured using the logarithm of the minimum angle of resolution (logMAR). BCVA, intraocular pressure (IOP), pupil diameter, and corneal endothelial cell count (CECC) preoperatively and postoperatively were statistically analyzed. The pupil shape, photophobia, IOL position, and surgical complications were evaluated.

RESULTS

The mean BCVA was significantly improved 6 months postoperatively (0.26 ± 0.17 logMAR, P = 0.042) than preoperatively (0.50 ± 0.30 logMAR). No significant difference was observed between the preoperative and postoperative IOP (P = 0.138). The mean pupil diameter significantly reduced postoperatively than preoperatively (3.44 ± 0.35 mm vs. 7.28 ± 0.35 mm, P = 0.043). There was no significant decrease in CECC postoperatively (P = 0.225). The pupil shape was round-like, and photophobia disappeared in all patients. No intraoperative or postoperative complications occurred.

CONCLUSION

Sutureless intrascleral IOL fixation combined with modified iris cerclage pupilloplasty is a safe and efficient procedure for treating aphakia traumatic mydriasis patients without sufficient capsular support.

摘要

目的

评估免缝线经巩膜眼内晶状体(IOL)固定联合改良虹膜环扎瞳孔成形术治疗无晶状体眼和外伤性瞳孔散大的安全性和有效性。

方法

同一位外科医生对 5 例无晶状体眼和外伤性瞳孔散大患者进行手术。所有患者均行免缝线经巩膜 IOL 固定联合改良虹膜环扎瞳孔成形术,并随访≥6 个月。使用最小角分辨率(logMAR)对数视力测量最佳矫正视力(BCVA)。对术前和术后的 BCVA、眼压(IOP)、瞳孔直径和角膜内皮细胞计数(CECC)进行统计学分析。评估瞳孔形状、畏光、IOL 位置和手术并发症。

结果

术后 6 个月平均 BCVA 明显提高(0.26±0.17 logMAR,P=0.042),优于术前(0.50±0.30 logMAR)。术前和术后 IOP 无显著差异(P=0.138)。术后平均瞳孔直径明显小于术前(3.44±0.35mm 比 7.28±0.35mm,P=0.043)。术后 CECC 无明显下降(P=0.225)。瞳孔形状呈圆形,所有患者畏光消失。术中及术后均无并发症发生。

结论

对于缺乏足够囊袋支持的无晶状体眼外伤性瞳孔散大患者,免缝线经巩膜 IOL 固定联合改良虹膜环扎瞳孔成形术是一种安全有效的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6572/11624642/2813c4b1de41/IJO-72-224-g001.jpg

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