Tourino-Peralba Rosario, Lamas-Francis David, Freijeiro-Gonzalez Laura, Martínez-Pérez Laura, Rodríguez-Ares Teresa
Department of Ophthalmology, University Hospital of Santiago de Compostela, Santiago, Spain.
Department of Surgery and Medical-Surgical Specialities, Faculty of Medicine, University of Santiago de Compostela, Santiago, Spain.
Clin Ophthalmol. 2024 Sep 20;18:2637-2644. doi: 10.2147/OPTH.S476047. eCollection 2024.
This study aims to analyze the incidence of pseudophakic macular edema (PME) and the role of contributing risk factors following prepupillary or retropupillary implantation of iris-claw lenses.
This retrospective cohort study included patients who underwent iris-claw intraocular lens implantation over a 16-year period at the University Hospital of Santiago de Compostela, Spain. The presence of risk factors for PME was recorded, and surgical outcomes included visual acuity, macular OCT scans, and description of complications.
A total of 148 eyes from 147 patients were included. Seventy-nine eyes (54.4%) underwent prepupillary iris-claw lens implantation and 69 eyes (46.6%) underwent retropupillary implantation. The mean age of the patients was 68.9 ± 17.2 years. The incidence of PME post-surgery was 23.0% (26.6% prepupillary and 18.8% retropupillary), and the mean time between surgery and diagnosis was similar for both locations (4.8 and 4.7 months, respectively). PME recurred in 33% of the patients, reaching a high rate of 72.7% when the lens location was prepupillary. The mean best-corrected visual acuity was 0.66±0.55 logMAR preoperatively and 0.38±0.50 logMAR postoperatively. Postoperative complications occurred in 29 patients (19.6%).
PME following iris-claw lens implantation tends to be more frequent and recurrent when the location is prepupillary. Planning for iris-claw lens surgery should consider the risk factors for the development of PME.
本研究旨在分析虹膜爪状晶状体在瞳孔前或瞳孔后植入后假晶状体性黄斑水肿（PME）的发生率及相关危险因素的作用。
这项回顾性队列研究纳入了在西班牙圣地亚哥德孔波斯特拉大学医院接受为期16年虹膜爪状人工晶状体植入术的患者。记录PME的危险因素，手术结果包括视力、黄斑OCT扫描及并发症描述。
共纳入147例患者的148只眼。79只眼（54.4%）接受了瞳孔前虹膜爪状晶状体植入，69只眼（46.6%）接受了瞳孔后植入。患者的平均年龄为68.9±17.2岁。术后PME的发生率为23.0%（瞳孔前为26.6%，瞳孔后为18.8%），两个部位手术至诊断的平均时间相似（分别为4.8个月和4.7个月）。33%的患者PME复发，当晶状体位于瞳孔前时复发率高达72.7%。术前平均最佳矫正视力为0.66±0.55 logMAR，术后为0.38±0.50 logMAR。29例患者（19.6%）发生术后并发症。
虹膜爪状晶状体植入术后，当晶状体位于瞳孔前时，PME往往更频繁且易复发。虹膜爪状晶状体手术规划应考虑PME发生的危险因素。
