John F. Hardesty Department of Ophthalmology and Visual Sciences (J.M.E., B.B., P.S., J.L., A.S.), Washington University in St. Louis School of Medicine, Saint Louis, Missouri, USA.
Kellogg Eye Center, Department of Ophthalmology and Visual Sciences (B.P., E.E., S.R., A.V., T.J.W., B.L.T., G.M.C., S.M., N.N.), University of Michigan, Ann Arbor, Michigan, USA; VA Ann Arbor Health Care System (B.P.), Ann Arbor, Michigan, USA; Uniformed Services University of the Health Sciences (B.P.), Bethesda, Maryland, USA.
Am J Ophthalmol. 2024 Jun;262:206-212. doi: 10.1016/j.ajo.2024.02.006. Epub 2024 Feb 17.
To report and evaluate a multicenter series of 18 cases of severe, spontaneous IOL tilt involving the flanged intrascleral haptic fixation technique (FISHF).
Clinical study with historical controls.
We report a cross-sectional study of 46 FISHF cases using the CT Lucia 602 IOL at a single academic center over a period of 24 weeks to determine the incidence of severe rotisserie-style rotational tilt. These rates were then compared with the same time-frame the prior year to help determine if this is a new phenomenon. Additional cases of severe tilt were solicited from another 4 academic centers.
Among 46 FISHF cases at a single center, 5 developed severe tilt. No clear pattern in surgical technique, ocular history, or ocular anatomy was evident in these cases compared with controls, although the involved IOLs clustered within a narrow diopter range, indicative of a batch effect. In the same 24-week interval the year before, 33 FISHF cases were performed, none of which exhibited severe rotational tilt. In our multicenter dataset, 18 cases of tilt were identified. Surgeons included fellow and early-career physicians as well as surgeons with multiple years of experience with the Yamane technique. A variety of surgical approaches for FISHF were represented. In at least 8 of the cases, haptic rotation and/or dehiscence at the optic-haptic junction were documented.
The identification of haptic rotation and dehiscence intraoperatively in several cases may reflect a new stability issue involving the optic-haptic junction.
报告和评估 18 例涉及有边巩膜扣带固定技术（FISHF）的严重自发性 IOL 倾斜的多中心系列病例。
临床研究，有历史对照。
我们报告了一项在单一学术中心使用 CT Lucia 602 IOL 的 46 例 FISHF 病例的横断面研究，以确定严重旋转式倾斜的发生率。然后将这些比率与前一年的相同时间段进行比较，以帮助确定这是否是一种新现象。还从另外 4 个学术中心征集了严重倾斜的其他病例。
在单一中心的 46 例 FISHF 病例中，有 5 例发生严重倾斜。与对照组相比，这些病例在手术技术、眼部病史或眼部解剖结构方面没有明显的模式，尽管涉及的 IOL 聚集在一个狭窄的屈光度范围内，表明存在批处理效应。在前一年的相同 24 周间隔内，进行了 33 例 FISHF 病例，均未出现严重的旋转倾斜。在我们的多中心数据集，确定了 18 例倾斜病例。涉及的外科医生包括研究员和早期职业医师以及具有多年 Yamane 技术经验的外科医生。代表了各种 FISHF 的手术方法。至少有 8 例病例记录了器械旋转和/或在器械-光学交界处的裂开。
在几个病例中术中发现器械旋转和裂开可能反映了涉及光学-器械交界处的新稳定性问题。
