晶状体囊袋不完整患者改良后房型人工晶状体无缝线巩膜层间固定术的效果

Efficacy of modified sutureless scleral fixation of posterior chamber intraocular lens for patients with insufficient capsular support

目的观察晶状体囊袋不完整患者改良后房型人工晶状体无缝线巩膜层间固定术的效果。设计回顾性病例系列。研究对象2018年6月至2019年5月海南省眼科医院晶状体囊袋不完整患者13例(13眼)。方法患者采用改良的后房型人工晶状体无缝线巩膜层间固定术治疗。回顾患者的病例资料。术前、术后1天、1周和1个月进行视力、验光、眼压等相关检查。主要指标视力(LogMAR)、屈光状态、眼压、手术时间、术中术后并发症。结果术前裸眼视力均值(1.58±0.08),术后1个月裸眼视力均值(0.70±0.11)(t=6.519,P=0.000);术前屈光均值(+10.54±0.35)D,术后1个月屈光均值(+0.73±0.39)D(t=16.284,P=0.000)。平均手术时长(27.92±10.18)分钟。术后低眼压1例,角膜水肿4例,均术后1周恢复。无人工晶状体脱位、虹膜夹持、人工晶状体袢暴露发生。结论短期随访结果显示,改良后房型人工晶状体无缝线巩膜层间固定术是晶状体囊袋不完整患者人工晶状体植入术的一种简单、安全、有效的术式。

Objective To observe the efficacy of modified sutureless scleral fixation of posterior chamber intraocular lens for patients with insufficient capsular support.Design Retrospective case series.Participants 13 cases(13 eyes)with loss of lens capsule in Hainan Provincial Ophthalmic Hospital from June 2018 to May 2019.Methods All patients underwent posterior chamber intraocular lens implantation with modified sutureless intrascleral fixation.The clinical data of patients were collected.Eye examination,including visual acuity,refrective examination,and intraocular pressure was performed before surgery and 1 day,1 week and 1 month after surgery.Main Outcome Measures visual acuity(LogMAR),refractive status,IOP,operation time,operative complications.Results The mean of preoperative naked eye vision was 1.58±0.08,postoperative naked eye vision was 0.70±0.11(t=6.519,P=0.000).Preoperative refractive mean 10.54±0.35 D,postoperative refractive mean 0.73±0.39 D(t=16.284,P=0.000).The duration of the operation was 27.92±10.18 minutes.Postoperative low intraocular pressure was 1 case,and postoperative corneal edema was 4 cases,which all recovered one week after operation.No intraocular lens dislocation,iris clamping and intraocular lens exposure occurred after operation.Conclusion This short-term result shows that modified sutureless intrascleral fixation of posterior chamber intraocular lens is a simple,safe and effective surgery for the fixation of intraocular lens with insufficient capsular support.