Kurniawan Chalid, Kartasasmita Arief S, Harley Ohisa
Department of Ophthalmology, Faculty of Medicine, Universitas Pasundan, Bandung, Indonesia.
Santosa Eye Center, Santosa Hospital, Bandung, Indonesia.
Narra J. 2024 Aug;4(2):e892. doi: 10.52225/narra.v4i2.892. Epub 2024 Aug 10.
Lens drop and intraocular lens (IOL) drop can occur after cataract or phacoemulsification surgery, where the IOL is dislocated from the capsular bag into the vitreous cavity. The aim of this study was to investigate the short-term outcomes of implanting a retropupillary iris-claw in patients with IOL drop and lens drop after phacoemulsification. A cross-sectional study was conducted at Santosa Hospital, Bandung, West Java, Indonesia, from January 2020 to December 2023. Patients were divided into two groups: IOL drop and lens drop groups. Total sampling was used, involving 51 patients in the present study, with 27 patients in the IOL drop group and 24 patients in the lens drop group. Data collected included age, sex, eye laterality, the onset of IOL drop or lens drop, intraocular pressure (IOP), uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), record of astigmatism change preoperative and postoperative, and postoperative pars plana vitrectomy (PPV) complications. Our data indicated that the UDVA significantly improved in both IOL drop and lens drop groups after PPV surgery (<0.001). However, there were no significant changes in IOP or astigmatism following the surgery in either group. Over one month, both groups showed improved UDVA, decreased IOP, and changes in astigmatism, with no significant differences between groups. Similarly, there was no significant difference in CDVA between IOL drop and lens drop groups. Only four complications were recorded in the present study. Comparing IOL drop and lens drop groups, only an increase in IOP showed a significant difference (=0.018). Corneal edema, IOL decentration, and pupil ovalization were not significantly different. In conclusion, retropupillary iris-claw IOL implantation is safe and effective for aphakic patients with complications from phacoemulsification, regardless of whether it is lens drop or IOL drop.
在白内障或超声乳化手术后可能会发生晶状体脱位和人工晶状体（IOL）脱位，即IOL从囊袋中脱入玻璃体腔。本研究的目的是调查在超声乳化术后发生IOL脱位和晶状体脱位的患者中植入瞳孔后虹膜爪型人工晶状体的短期效果。2020年1月至2023年12月在印度尼西亚西爪哇万隆的Santosa医院进行了一项横断面研究。患者分为两组：IOL脱位组和晶状体脱位组。采用全样本抽样，本研究共纳入51例患者，其中IOL脱位组27例，晶状体脱位组24例。收集的数据包括年龄、性别、患眼侧别、IOL或晶状体脱位的发生时间、眼压（IOP）、未矫正远视力（UDVA）、矫正远视力（CDVA）、术前和术后散光变化记录以及术后玻璃体切割术（PPV）并发症。我们的数据表明，PPV手术后IOL脱位组和晶状体脱位组的UDVA均显著改善（<0.001）。然而，两组手术后IOP或散光均无显著变化。在一个多月的时间里，两组的UDVA均有所改善，IOP降低，散光也有变化，两组之间无显著差异。同样，IOL脱位组和晶状体脱位组的CDVA也无显著差异。本研究仅记录到4例并发症。比较IOL脱位组和晶状体脱位组，仅IOP升高显示出显著差异（=0.018）。角膜水肿、IOL偏心和瞳孔椭圆化无显著差异。总之，对于因超声乳化术出现并发症的无晶状体患者，无论发生的是晶状体脱位还是IOL脱位，瞳孔后虹膜爪型IOL植入都是安全有效的。
