Li Ning, Dong Jie, Wang Jianfeng, Ren Xiaohui, Guo Juanjuan, Li Juan, Gao Ziqing
Department of Ophthalmology, The First Affiliated Hospital of Bengbu Medical University, Bengbu, China.
Department of Ophthalmology, Shenyang Fourth People's Hospital, Shenyang, China.
Front Med (Lausanne). 2025 Mar 25;12:1569767. doi: 10.3389/fmed.2025.1569767. eCollection 2025.
Traumatic rupture of the lens zonules, leading to lens dislocation, is common in clinical practice and often requires surgical treatment. We aim to study capsular hooks, formed from 5-0 or 6-0 polypropylene sutures by heat shaping, to fix the capsular bag and reshape the lens zonular.
A retrospective analysis was conducted on 16 patients (16 eyes) with traumatic subluxation of the crystalline lens who visited our department. Capsular hooks were fabricated using 5-0 or 6-0 polypropylene sutures, shape by heat, to fix the anterior capsular opening. The sutures passed out of the eye, punctured the sclera and traversed it parallel to the limbus for 2-3 mm, exiting through the conjunctiva to form a suture tunnel parallel to the limbus, securing the suture and preventing loosening. Changes in best-corrected visual acuity (BCVA) after surgery, intraocular lens centration, and surgical complications were assessed.
Post-operative follow-up was 6-30 months, with an average of 10 ± 5.9 months. The BCVA improved from a pre-operative median of 2.15 (1.67) logMAR to a postoperative median of 0.25 (0.38) logMAR (paired sample Wilcoxon signed-rank test, = 3.516, < 0.001). Postoperatively, the intraocular lenses were well-centered, the capsular bags were securely fixed, and no capsular hooks dislodgement occurred. One patient experienced combined vitreous hemorrhage during surgery. Another patient (case 2) developed rhegmatogenous retinal detachment 2 years post-surgery. After pars plana vitrectomy, the retina was reattached, and the final visual acuity remained stable.
Long-term follow-up data suggest that using custom-made capsular hooks offers a reliable solution for maintaining long-term stability of the capsular bag in patients with traumatic crystalline lens subluxation. This technique maintains the centering of the IOL postoperatively, showing effectiveness and safety, and it holds potential for broader clinical application.
晶状体悬韧带外伤性断裂导致晶状体脱位在临床实践中较为常见，通常需要手术治疗。我们旨在研究由5-0或6-0聚丙烯缝线经热塑形制成的囊钩，以固定囊袋并重塑晶状体悬韧带。
对我院就诊的16例（16眼）外伤性晶状体半脱位患者进行回顾性分析。使用5-0或6-0聚丙烯缝线制作囊钩，通过加热塑形来固定前囊开口。缝线穿出眼球，穿刺巩膜并与角膜缘平行穿过2-3毫米，经结膜穿出形成与角膜缘平行的缝线隧道，固定缝线并防止松动。评估术后最佳矫正视力（BCVA）变化、人工晶状体中心定位及手术并发症。
术后随访6-30个月，平均为10±5.9个月。BCVA从术前中位数2.15（1.67）logMAR提高到术后中位数0.25（0.38）logMAR（配对样本Wilcoxon符号秩检验，Z = 3.516，P < 0.001）。术后人工晶状体中心定位良好，囊袋固定牢固，未发生囊钩移位。1例患者术中合并玻璃体出血。另1例患者（病例2）术后2年发生孔源性视网膜脱离。经玻璃体切割术后视网膜复位，最终视力保持稳定。
长期随访数据表明，使用定制囊钩为外伤性晶状体半脱位患者维持囊袋长期稳定性提供了可靠的解决方案。该技术术后能保持人工晶状体的中心定位，显示出有效性和安全性，具有更广泛的临床应用潜力。
