Comparison of Artisan iris-claw intraocular lens implantation and posterior chamber intraocular lens sulcus fixation for aphakic eyes

AIM:To compare the efficacy and complications of Artisan iris-claw intraocular lens(IOL)implantation and posterior chamber IOL sulcus fixation for the treatment of aphakic eyes without capsular support after vitrectomy.METHODS:A prospective study of 45 cases was conducted.Forty-five eyes without sufficient lens capsule support following pars plana vitrectomy(PPV)combined lens extraction were divided into two groups.Group A:25 eyes received Artisan iris-claw IOL implantation.Group B:20 eyes received posterior chamber IOL sulcus fixation.The corrected distance visual acuity(CDVA)and intraocular pressure(IOP),corneal endothelial cell loss rate,surgical time and complications were compared between the two groups.Pigment changes of trabecular meshwork and anterior chamber depths were measured at each time point in Artisan group.RESULTS:The mean surgical time of Artisan group was significantly shorter(P【0.05).No statistically significant difference in endothelial cell loss rate was noted between two groups at any time point(P】0.05).CDVA of Artian group was better than that of the sulcus fixation group 1d after surgery(P【0.05)and there was no statistically significant difference 1 and 3mo after surgery(P】0.05).Mean IOP showed no significant differences between groups before and after surgery.The postoperative complications of Artisan group were anterior uveitis,iris depigmentation,pupillary distortion and spontaneous lens dislocation.The complications of sulcus fixation group include choroidal detachment,intraocular haemorrhage,tilt of IOL optic part and retinal detachment.CONCLUSION:Secondary Artisan IOL implantation canbe performed less invasively and in a shorter surgical time period with earlier visual recovery after surgery compared to transscleral suturing fixation of an IOL.This technique is an effective and safe procedure.It is a promising option for the treatment of aphakic eyes without capsular support after vitrectomy.

晶状体玻璃体切除术后折叠人工晶状体睫状沟悬吊术的效果

目的评价晶状体玻璃体切除术后无晶状体眼折叠人工晶状体睫状沟悬吊术的临床疗效。方法回顾性分析22例（22眼）玻璃体切除术后的无晶状体眼的临床资料，均经角膜缘行小切VI折叠人工晶状体睫状沟悬吊术。随访6～30个月。结果术中眼压平稳，未出现眼球塌陷、脉络膜脱离、视网膜脱离或脉络膜下爆发性出血等并发症。术后早期5眼出现低眼压，4眼出现高眼压，经药物治疗5～7d后眼压恢复正常；3眼出现少量玻璃体积血，7d后积血吸收。术后末次随访最佳矫正视力均等于或优于术前最佳矫正视力，人工晶状体位置稳定。未出现角膜内皮失代偿、脉络膜下出血、缝线外露、眼内炎、继发性青光眼、视网膜脱离或眼球萎缩等严重并发症。结论经角膜缘小切口行折叠人工晶状体睫状沟悬吊术治疗晶状体玻璃体切除术后无晶状体眼，手术损伤小，并发症少，安全有效。但其远期效果仍需要长期随访观察。