Piyasoonthorn Pratan, Gacivut Puntanarach
Ophthalmology Department, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand; and.
Chulabhorn Ophthalmology Technology Center, Chulabhorn Hospital, Bangkok, Thailand.
Cornea. 2024 Jun 1;43(6):795-798. doi: 10.1097/ICO.0000000000003520. Epub 2024 Mar 21.
To develop a new, sutureless intrascleral intraocular lens (IOL) fixation technique based on the Yamane double-needle and Canabrava 4-flanged techniques.
The Fusion-Flanged technique involves using a 7-0 polypropylene suture loop threaded through the eyelets of the IOL. Afterward, both ends of the suture are passed outside the eye through a 27-gauge needle. This technique creates a single flange by joining the 2 suture ends through handheld cautery, and this flange is then embedded into the scleral tunnel to securely fix the IOL in place.
This technique was performed on a total of 7 aphakic patients. Four of them had encountered complications following manual small incision cataract surgery, while the remaining 3 experienced complications after phacoemulsification. The results indicated a significant improvement in visual acuity, with mean preoperative and postoperative corrected distance visual acuities of 0.77 ± 0.11 and 0.27 ± 0.08 (logarithm of the minimum angle of resolution [logMAR] units), respectively.
The Fusion-Flanged intrascleral IOL fixation technique offers improvements in simplicity, safety, and the overall efficiency when compared to existing sutureless intrascleral fixation techniques. Notably, this technique is versatile and can be applied to both non-foldable and foldable IOLs.
基于Yamane双针技术和Canabrava四凸缘技术开发一种新的无缝合巩膜内人工晶状体(IOL)固定技术。
融合凸缘技术包括使用一个7-0聚丙烯缝线环穿过IOL的小孔。之后,缝线的两端通过一根27号针穿出眼外。该技术通过手持烧灼将两根缝线末端连接起来形成一个单一的凸缘,然后将这个凸缘嵌入巩膜隧道以将IOL牢固地固定到位。
该技术共应用于7例无晶状体患者。其中4例在手法小切口白内障手术后出现并发症,其余3例在超声乳化术后出现并发症。结果显示视力有显著改善,术前和术后平均矫正远视力分别为0.77±0.11和0.27±0.08(最小分辨角对数[logMAR]单位)。
与现有的无缝合巩膜内固定技术相比,融合凸缘巩膜内IOL固定技术在操作简便性、安全性和整体效率方面有所提高。值得注意的是,该技术具有通用性,可应用于非折叠式和折叠式IOL。