Tiosano Alon, Sella Ruti, Gal-Or Orly, Zlatkin Rita, Ehrlich Rita, Bahar Irit
Department of Ophthalmology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel.
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Ophthalmologica. 2025;248(2):81-88. doi: 10.1159/000543255. Epub 2024 Dec 23.
The aim of our study was to assess the outcome of Gore-Tex sutures in minimally invasive scleral fixation of subluxated posterior chamber intraocular lenses (PCIOLs) and to demonstrate a method for validating the lens position.
Retrospective study of patients who underwent lasso in-the-bag scleral fixation of a subluxated PCIOL using the snare technique with Gore-Tex suture from 2019 to 2021 in a single tertiary medical center. Functional outcome was analyzed by clinical assessment, and anatomical outcome, by ultrasound biomicroscopy (UBM).
A total of 18 eyes were included. The mean duration of follow-up was 140 days (range 23-659), and the median time from PCIOL implantation to fixation was 8.5 years (IQR 6.25-10.75). All patients had ocular comorbidities, mainly glaucoma (n = 6) and pseudoexfoliation syndrome (n = 5). Best corrected visual acuity improved from a median of 6/30 (0.7 logMAR) to a median of 6/12 (0.35 logMAR) (p = 0.06); postoperative astigmatism measured 0.91 ± 2.19 diopters. UBM demonstrated well-balanced PCIOL fixation with no difference between the horizontal and vertical tilt measurements (p = 0.84; p = 0.94; p = 0.62; p = 0.085). The fixated PCIOL showed <10% decentration with reference to the visual axis. There was a high negative correlation between BCVA improvement and residual lens tilt (r = -0.76, p = 0.037). Postoperative complications included transient ocular hypertension (n = 3), corneal decompensation with subsequent keratoplasty (n = 3), temporary hypotony (n = 2), cystoid macular edema (n = 1), suture exposure (n = 1), and endophthalmitis (n = 1).
Subluxated PCIOLs are amenable to treatment with minimally invasive fixation using Gore-Tex suture with good anatomic outcomes. UBM image analysis may serve as a valuable method for assessing PCIOL position following scleral fixation.
我们研究的目的是评估戈尔特斯缝线在半脱位后房型人工晶状体（PCIOL）微创巩膜固定术中的效果，并展示一种验证晶状体位置的方法。
对2019年至2021年在一家三级医疗中心接受使用戈尔特斯缝线的圈套器技术进行半脱位PCIOL囊内巩膜固定术的患者进行回顾性研究。通过临床评估分析功能结果，通过超声生物显微镜（UBM）分析解剖结果。
共纳入18只眼。平均随访时间为140天（范围23 - 659天），从PCIOL植入到固定的中位时间为8.5年（四分位间距6.25 - 10.75年）。所有患者均有眼部合并症，主要为青光眼（n = 6）和假性剥脱综合征（n = 5）。最佳矫正视力从中位的6/30（0.7 logMAR）提高到中位的6/12（0.35 logMAR）（p = 0.06）；术后散光为0.91±2.19屈光度。UBM显示PCIOL固定良好，水平和垂直倾斜测量无差异（p = 0.84；p = 0.94；p = 0.62；p = 0.085）。固定后的PCIOL相对于视轴的偏心度<10%。最佳矫正视力改善与残余晶状体倾斜之间存在高度负相关（r = -0.76，p = 0.037）。术后并发症包括短暂性高眼压（n = 3）、角膜失代偿并随后进行角膜移植术（n = 3）、暂时性低眼压（n = 2）、黄斑囊样水肿（n = 1）、缝线外露（n = 1）和眼内炎（n = 1）。
半脱位的PCIOL适合使用戈尔特斯缝线进行微创固定治疗，解剖效果良好。UBM图像分析可作为评估巩膜固定术后PCIOL位置的有价值方法。
