Kumari Neha, Anand Abhishek, Sinha Rajnee, Ali Mobashir, Sinha Shivani, Sinha Bibhuti
Ophthalmology, Indira Gandhi Institute of Medical Sciences, Patna, IND.
Cureus. 2024 Dec 21;16(12):e76154. doi: 10.7759/cureus.76154. eCollection 2024 Dec.
Lens implantation becomes a major concern in patients lacking posterior capsular support, but various methods are available for rehabilitation. In such patients, scleral-fixated intraocular lens (SFIOL) implantation is preferred due to its fewer complications and better simulation of the natural lens position. In this non-randomized retrospective clinical study, we aimed to assess visual outcomes after sutureless SFIOL implantation in aphakic patients and factors affecting visual outcomes.
The study was conducted at the Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India, wherein a retrospective data analysis of hospital medical records of aphakic cases who underwent SFIOL implantation from January 2020 to December 2022 was performed. Patients with poor capsular and iris support, lens subluxation of >180°, dislocated natural crystalline lens, or intraocular lens were included in the study. Preoperative data such as aphakia etiology, pre-op best-corrected visual acuity (BCVA), intraocular pressure (IOP), and any other ocular pathology, as well as postoperative data (i.e., BCVA, IOP, haptic status, and complications), were collected and analyzed.
A total of 45 patients underwent non-sutured multipiece SFIOL implantation. The average preoperative BCVA was 1.73±0.24 (in LogMAR, logarithm of the minimum angle of resolution), which improved to 0.87±0.27 six months after surgery. Out of 45 patients, 41 (91.1%) reported increased BCVA. The most common intraoperative and postoperative complications were astigmatism, raised IOP, and corneal edema. Four (8.9%) patients had no change in BCVA due to pre-existing conditions. No patient required a second surgery for retinal detachment or dislocation of SFIOL. Two (4.4%) patients underwent laser treatment for a retinal break found incidentally during surgery.
Sutureless SFIOL demonstrates predictable outcomes post-aphakia. Patient outcomes ultimately depend on the presence of postoperative astigmatism and coexistent anterior and posterior segment pathologies. Surgeons should take appropriate care to avoid IOL tilt and postoperative astigmatism.
对于缺乏后囊膜支撑的患者，晶状体植入成为一个主要问题，但有多种方法可用于恢复。在此类患者中，巩膜固定人工晶状体（SFIOL）植入因其并发症较少且能更好地模拟自然晶状体位置而更受青睐。在这项非随机回顾性临床研究中，我们旨在评估无晶状体患者无缝合SFIOL植入后的视觉效果以及影响视觉效果的因素。
该研究在印度比哈尔邦巴特那的英迪拉·甘地医学科学研究所进行，对2020年1月至2022年12月期间接受SFIOL植入的无晶状体病例的医院病历进行回顾性数据分析。纳入囊膜和虹膜支撑差、晶状体半脱位>180°、自然晶状体脱位或人工晶状体脱位的患者。收集并分析术前数据，如无晶状体病因、术前最佳矫正视力（BCVA）、眼压（IOP）和任何其他眼部病变，以及术后数据（即BCVA、IOP、襻状态和并发症）。
共有45例患者接受了非缝合多片式SFIOL植入。术前平均BCVA为1.73±0.24（以最小分辨角的对数，即LogMAR表示），术后6个月提高到0.87±0.27。45例患者中，41例（91.1%）报告BCVA提高。最常见的术中及术后并发症是散光、眼压升高和角膜水肿。4例（8.9%）患者因原有病情BCVA无变化。没有患者因视网膜脱离或SFIOL脱位而需要二次手术。2例（4.4%）患者因手术中偶然发现的视网膜裂孔接受了激光治疗。
无缝合SFIOL在无晶状体术后显示出可预测的结果。患者的最终结果最终取决于术后散光的存在以及并存的眼前段和眼后段病变。手术医生应采取适当措施避免人工晶状体倾斜和术后散光。
