一种免缝合巩膜层间固定人工晶状体方法的临床应用

Clinical application of a sutureless intrascleral intraocular lens fixation method

目的初步评估一种免缝合巩膜层间固定人工晶状体方法的有效性及安全性。方法回顾性病例研究。分析就诊于我院眼科需行人工晶状体巩膜层间固定的12例(12只眼)患者临床资料。术中制作两个对称的平行于角膜缘的反向巩膜隧道,用1 ml注射器针头分别从两个隧道内引出人工晶状体的两个襻,采用加热的方法使其末端向晶状体体部弯曲90°呈L型,并埋置于隧道内。观察患者手术前后视力、眼压等变化,并记录术中术后并发症。结果12例患者平均随访时间(7.42±1.8)个月,术后末次随访时术眼最佳矫正视力与术前最佳矫正视力相比无统计学差异(P>0.05)。无术中术后并发症发生。末次随访时所有患者的人工晶状体位置无倾斜,居中良好。结论人工晶状体襻L形弯曲在人工晶状体巩膜层间固定术中的应用是方便、有效、安全的,可以克服传统人工晶状体悬吊的缝线相关并发症,同时在术后获得满意的人工晶状体位置和视觉质量。

Objective To evaluate the efficacy and safety of a sutureless intrascleral intraocular lens(IOL)fixation method.Methods Retrospective case study.A total of 12 patients(12 eyes)who underwent intrascleral IOL fixation in our hospital were retrospectively analyzed.Two limbus-parallel scleral tunnels were made at opposite positions.The two haptics of an IOL were introduced through the two scleral tunnels,respectively with a 1 ml syringe needle.Then the end of IOL haptics were cauterized to an L-shape and fixed in the scleral tunnel.The changes of uncorrected visual acuity(UCVA),best-corrected visual acuity(BCVA),intraocular pressure before and after the operation were recorded,as well as the intraoperative and postoperative complications.Results The mean follow-up period was 7.42±1.8 months.The BCVA at last follow-up improved significantly compared with the preoperative UCVA(P<0.01).There was no statistically significant difference between the last follow-up BCVA and preoperative BCVA(P>0.5).No postoperative complications were observed during the follow-up period.The IOLs were fixed and well centered.Conclusions Intrascleral IOL fixation with L-shaped bending of the IOL haptics could be an effective and safe surgical technique,which has the potential benefit to minimize the complications after sutured IOL fixation technique.This technique could also obtain satisfactory postoperative IOL position and visual quality.