Pavlin C J, Rootman D, Arshinoff S, Harasiewicz K, Foster F S
Department of Ophthalmology, Princess Margaret Hospital, Toronto, Ontario, Canada.
J Cataract Refract Surg. 1993 Sep;19(5):573-7. doi: 10.1016/s0886-3350(13)80002-8.
Transscleral fixation of posterior chamber intraocular lenses has become an increasingly popular procedure in eyes lacking adequate posterior capsular support. The assumption is generally made that these lenses are fixated in the ciliary sulcus. To test this assumption, 17 cases with transsclerally fixated posterior chamber intraocular lenses were examined with ultrasound biomicroscopy, a new method of producing subsurface images in living eyes at microscopic resolution. All lens haptics were easily visualized with this technique. Of 34 haptics in 17 patients, 13 were adequately located in the sulcus region, eight were located posterior to the ciliary processes, and 13 were located anterior to the sulcus region, accompanied by some degree of angle closure. Haptics with a more posterior scleral exit of the suture tended to be located more posteriorly. The cases in which the haptics were located anteriorly had scleral exit points from 1 mm to 2 mm from the limbus. The surgical placement of transsclerally fixated lenses is a blind procedure in most cases. Our series demonstrates the difficulty in reliably placing the haptics in the ciliary sulcus.
对于缺乏足够后囊膜支撑的眼睛，经巩膜固定后房型人工晶状体已成为一种越来越受欢迎的手术。一般认为这些晶状体固定在睫状沟内。为了验证这一假设，我们使用超声生物显微镜对17例经巩膜固定后房型人工晶状体的病例进行了检查，这是一种能在活体眼中以微观分辨率生成眼内图像的新方法。通过该技术可以轻松观察到所有晶状体袢。在17例患者的34个晶状体袢中，13个位于沟区域，8个位于睫状突后方，13个位于沟区域前方，并伴有一定程度的房角关闭。缝线在巩膜上出口越靠后的袢往往位置更靠后。袢位于前方的病例，其巩膜出口点距离角膜缘1毫米至2毫米。在大多数情况下，经巩膜固定人工晶状体的手术放置是一种盲操作。我们的系列研究表明，将袢可靠地放置在睫状沟内存在困难。
