Huang XiaoJia, Zhou Zhou, Huang ShanShan, He Wenjing, Chen Qi, Shen Chaolan, Zhong Haibin, Yang Ke, Cui Ling, Xu Fan, Yao Gang
Department of Ophthalmology, Guangxi Key Laboratory of Eye Health & Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology, the People's Hospital of Guangxi Zhuang Autonomous Region & Institute of Ophthalmic Diseases, Guangxi Academy of Medical Sciences, Nanning, 530021, Guangxi, China.
BMC Ophthalmol. 2025 May 13;25(1):290. doi: 10.1186/s12886-025-04105-9.
Rescuing dislocated intraocular lenses (IOLs) with eyelets after scleral suture fixation presents technical challenges and risks of ocular tissue damage. We propose a novel in-situ rescue technique for repositioning dislocated IOLs with fixation eyelets. This approach avoids large incisions, accommodates dislocations in any direction, and offers a safer, more efficient alternative to traditional methods.
The technique was performed on four patients with dislocated IOLs following scleral suture fixation. Under retrobulbar anesthesia, a retrograde suture-guided approach was employed. A double-armed polypropylene suture was introduced retrogradely into the eye via a puncture site. The suture arms were threaded through the fixation eyelet of the IOL haptic. One arm was then cut and hooked out through the eyelet. The broken ends of the two sutures were tied together. The IOL was adjusted to its proper position, and the suture was tightened to secure it to the sclera.
All four patients underwent successful in-situ IOL refixation without intraoperative complications. Postoperative examinations confirmed well-centered IOLs in all cases. Postoperative vision has significantly improved compared to preoperative vision. Over a follow-up period of 11-36 months, no redislocation or major complications were observed.
This in-situ rescue technique provides a safe, effective, and straightforward solution for fixing dislocated perforated IOLs. Its simplicity and positive outcomes position it as a promising option for managing these complex cases.
巩膜缝线固定术后使用带小孔的人工晶状体（IOL）复位脱位的人工晶状体存在技术挑战和眼组织损伤风险。我们提出一种用于重新定位带固定小孔的脱位人工晶状体的新型原位复位技术。这种方法避免了大切口，可适应任何方向的脱位，并且为传统方法提供了一种更安全、更有效的替代方案。
对4例巩膜缝线固定术后人工晶状体脱位的患者实施了该技术。在球后麻醉下，采用逆行缝线引导法。通过穿刺部位将双臂聚丙烯缝线逆行引入眼内。缝线臂穿过人工晶状体襻的固定小孔。然后切断其中一臂并通过小孔钩出。将两根缝线的断端系在一起。调整人工晶状体至合适位置，并收紧缝线以将其固定在巩膜上。
所有4例患者均成功进行了人工晶状体原位重新固定，术中无并发症。术后检查证实所有病例的人工晶状体均位于中心良好。与术前视力相比，术后视力有显著改善。在11至36个月的随访期内，未观察到再脱位或重大并发症。
这种原位复位技术为固定脱位的带孔人工晶状体提供了一种安全、有效且直接的解决方案。其简单性和良好效果使其成为处理这些复杂病例的一个有前景的选择。
