Navia-Aray E A
Department of Ophthalmology, Guayaquil City Hospital, Ecuador.
J Refract Corneal Surg. 1994 Sep-Oct;10(5):565-70.
I have previously reported a new technique of suture fixation of a posterior chamber intraocular lens (IOL) to the iris through a limbal incision in the absence of a posterior lens capsule. This study evaluated the results of that technique as an alternative to anterior chamber lens implantation or suturing of a posterior chamber lens through the ciliary sulcus and sclera.
The clinical records of 30 consecutive eyes that underwent this procedure between September 1987 and February 1991 were studied retrospectively. Four sutures were attached to four holes in the optic of a posterior chamber IOL. Two sutures on straight needles were passed through a superior limbal wound, to the pupil, reaching the inferior iris to be tied onto this iris. The two upper sutures on curved needles were passed through the pupil and going to the superior iris and then tied.
An anterior vitrectomy was done in the pupil in 18 (60%) eyes. The mean postoperative follow-up time was 40 months (range, 24 to 66 months). Nineteen eyes (63%) had visual acuities of 20/40 or better; and 10 eyes (33%) had visual acuities between 20/50 and 20/80. The remaining eye had persistent cystoid macular edema, proven by fluorescein angiography, with 20/100 visual acuity. No serious anterior segment complications occurred. There was mild pigment dispersion on the IOL in four eyes. Four eyes needed timolol drops to lower the intraocular pressure.
This technique offers a viable alternative to transscleral fixation of a posterior chamber IOL via a limbal approach.
我之前曾报道过一种在没有晶状体后囊的情况下，通过角膜缘切口将后房型人工晶状体（IOL）缝合固定于虹膜的新技术。本研究评估了该技术作为前房型人工晶状体植入或通过睫状沟和巩膜缝合后房型人工晶状体的替代方法的效果。
回顾性研究了1987年9月至1991年2月间连续30只接受该手术的眼睛的临床记录。将四根缝线附着于后房型IOL光学部的四个孔上。两根直针上的缝线穿过上方角膜缘切口，进入瞳孔，到达下方虹膜并系于该虹膜上。两根弯针上的上方缝线穿过瞳孔，到达上方虹膜，然后系紧。
18只（60%）眼睛在瞳孔区进行了前部玻璃体切除术。术后平均随访时间为40个月（范围24至66个月）。19只眼睛（63%）视力达到20/40或更好；10只眼睛（33%）视力在20/50至20/80之间。其余一只眼睛经荧光素血管造影证实存在持续性黄斑囊样水肿，视力为20/100。未发生严重的前段并发症。4只眼睛的人工晶状体上有轻度色素播散。4只眼睛需要使用噻吗洛尔滴眼液降低眼压。
该技术通过角膜缘入路为后房型人工晶状体的经巩膜固定提供了一种可行的替代方法。
