Day H Russell, Nair Archana A, Finn Avni P
Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, TN, USA.
J Vitreoretin Dis. 2025 Feb 10:24741264251315156. doi: 10.1177/24741264251315156.
To compare the visual outcomes and postoperative complications after simultaneous scleral-sutured intraocular lens (IOL) placement and pars plana vitrectomy (PPV) (simultaneous group) with those of IOL implantation staged after PPV (staged group). In this retrospective cohort study, cases of scleral-sutured IOL placement were reviewed between July 1, 2016, and December 31, 2022. All patients had scleral-sutured Akreos AO60 IOL placement using 4-point fixation. Of the 98 eyes, 83.7% had simultaneous surgery and 16.3% had staged surgery. The mean preoperative visual acuity (VA) was similar between the staged group and simultaneous group (1.8 logMAR [Snellen equivalent, 20/1262] vs 1.3 logMAR [Snellen equivalent, 20/400]; = .104]. The mean logMAR VA improved to 0.98 (Snellen equivalent, 20/191) and to 0.50 (Snellen equivalent, 20/63), respectively. The median logMAR improvement was 0.93 (Snellen equivalent, 20/170) in the staged group and 0.80 (Snellen equivalent, 20/126) in the simultaneous group ( = .49). The overall transient postoperative hypotony rate was 8.2%, with all cases occurring in the simultaneous group ( = .194). Both staged surgery and simultaneous PPV with scleral-sutured Akreos AO60 IOL placement are safe and efficacious procedures for visual rehabilitation in patients with dislocated IOLs, retained lens material, and aphakia resulting from other causes. Staged scleral-sutured Akreos AO60 IOL placement after PPV may offer a safe approach for eyes with significant ocular comorbidities and decrease the risk for transient postoperative hypotony.
比较巩膜缝合人工晶状体（IOL）植入联合玻璃体切除术（PPV）（同期组）与PPV术后分期植入IOL（分期组）后的视觉效果和术后并发症。在这项回顾性队列研究中，对2016年7月1日至2022年12月31日期间巩膜缝合IOL植入的病例进行了回顾。所有患者均采用四点固定法进行巩膜缝合Akreos AO60 IOL植入。98只眼中，83.7%为同期手术，16.3%为分期手术。分期组和同期组术前平均视力（VA）相似（1.8 logMAR[Snellen等效值，20/1262]对1.3 logMAR[Snellen等效值，20/400]；P = 0.104）。平均logMAR VA分别提高到0.98（Snellen等效值，20/191）和0.50（Snellen等效值，20/63）。分期组logMAR改善中位数为0.93（Snellen等效值，20/170），同期组为0.80（Snellen等效值，20/126）（P = 0.49）。术后总体短暂性低眼压率为8.2%，所有病例均发生在同期组（P = 0.194）。PPV联合巩膜缝合Akreos AO60 IOL植入的分期手术和同期手术对于人工晶状体脱位、残留晶状体物质以及其他原因导致的无晶状体眼患者的视力恢复都是安全有效的手术方法。PPV术后分期巩膜缝合Akreos AO60 IOL植入可能为有严重眼部合并症的患者提供一种安全的方法，并降低术后短暂性低眼压的风险。
