Purpose: To develop a new technique for fixation of posterior chamber intraocular lens (IOL) in the absence of posterior capsule support.Materials and Methods: We performed non-trans-scleral fixation of intraocular le...Purpose: To develop a new technique for fixation of posterior chamber intraocular lens (IOL) in the absence of posterior capsule support.Materials and Methods: We performed non-trans-scleral fixation of intraocular lenses on 24 cases (24 eyes) without posterior capsule support. Two scleral flaps with limbal incisions and two peripheral iridectomies were made at 1 o' clock and 7 o' clock positions respectively. A suture-leading needle was used to lead the prolene suture from the limbal incision and iridectomy on one side through the iridectomy and limbal incision on the other side. Intraocular lens (IOL) was then fixed in the ciliary sulcus. Results: After a mean follow-up of 6. 6 months (range from 3 to 14 months), corrected visual acuity of 16 cases (16 eyes,66. 7% ) got 0.5 or better. Postoperative complications included discoria (4 eyes) , surface membrane formation ( 1 eye ), choroidal detachment (1 eye) and tilt of IOL (1 eyes),but all were not severe. Conclusion: In some situations such as low展开更多
AIM: To study the impact of scleral flap position, under which the posterior chamber intraocular lenses (PC-IOL) were sulcus-fixed by trans-scleral suture, on cornea astigmatism. METHODS: Twenty-six aphakic or catarac...AIM: To study the impact of scleral flap position, under which the posterior chamber intraocular lenses (PC-IOL) were sulcus-fixed by trans-scleral suture, on cornea astigmatism. METHODS: Twenty-six aphakic or cataract eyes were comprised in this prospective noncomparative case series study. Eleven eyes had traumatic cataract removed without sufficient capsular support, 3 had blunt trauma with subluxated traumatic cataract, 8 had undergone vitreoretinal surgery and 4 had congenital cataract removed. The average age was 54 years (range 21-74 years), with 17 men and 7 women. The foldable PC-IOL was fixed in sulcus by trans-scleral suture. The incision for IOL implantation was made 1mm posterior to limbus along the steepest meridian of cornea, while scleral flaps to bury the knots of trans-scleral suture were made along the flattest meridian. All the surgeries were performed by a single doctor (Ma L), and the follow up was at least 13 months (range 13-28 months). The preoperative, 3 months and 1 year postoperative corneal curvature along the steepest and flattest cornea meridian and overall cornea astigmatism were compared. RESULTS: The curvature along the steepest meridian changed from 44.25 +/- 2.22D preoperatively to 44.08 +/- 2.16D at 3 months postoperatively, and 43.65 +/- 5.23D at 1 year postoperatively (P>0.05); the curvature along the flattest meridian changed from 41.24 +/- 2.21D preoperatively to 43.15 +/- 3.94D at 3 months postoperatively, and 42.85 +/- 5.17D at 1 year postoperatively (P<0.05); and the surgery induced astigmatism (SIA) on cornea was calculated by vector analysis, which was 2.42 +/- 2.13D at 3 months postoperatively, and 2.18 +/- 3.42D at 1 year postoperatively, the difference was statistically significant (P<0.05). CONCLUSION: The scleral flap made along the flattest meridian, under which the posterior chamber intraocular lenses (PCIOL) were sulcus-fixed by trans-scleral suture, can steepen the cornea in varying degrees, thus reducing preexisting corneal astigmatism.展开更多
AIM:To evaluate the safety and efficacy of scleral-fixated 3-looped haptics intraocular lens(IOL)implantation for surgical management of microspherophakia.METHODS:A retrospective case series include 10 microspherophak...AIM:To evaluate the safety and efficacy of scleral-fixated 3-looped haptics intraocular lens(IOL)implantation for surgical management of microspherophakia.METHODS:A retrospective case series include 10 microspherophakic patients(15 eyes)who underwent lens removal plus a modified surgical treatment of scleral-fixated 3-looped haptics IOL implantation.The primary outcomes involved visual acuity,intraocular pressure(IOP).Secondary outcomes were spherical equivalent(SE),anterior chamber depth(ACD),corneal endothelial cell density and postoperative complications.RESULTS:After a postoperative follow-up of 17.60±15.44mo,improved visual outcomes can be observed.The uncorrected distance visual acuity(UCVA)log MAR improved from 1.54±0.59 preoperatively to 0.51±0.35 postoperatively(P=0.001),and best corrected visual acuity(BCVA)log MAR improved from 0.97±0.91 preoperatively to 0.24±0.23 postoperatively(P=0.003).Moreover,the SE decreased from-9.58±7.47D preoperatively to-0.65±2.21 D postoperatively(P<0.001).In terms of safety profile,the average IOP decreased from 21.10±12.94 mm Hg preoperatively to 14.03±3.57 mm Hg postoperatively(P=0.044),and the previously elevated IOP of three eyes decreased to the normal range.The ACD increased from 2.25±1.45 mm preoperatively to 3.35±0.39 mm postoperatively(P=0.017).The density of corneal endothelial cells did not change significantly after surgery(P=0.140).The posterior chamber IOLs were well centered and no severe complications were found.CONCLUSION:Lens removal plus the modified surgical treatment of scleral-fixated 3-looped haptics IOL implantation can help in improvement of visual acuity,which can be regarded as a relative safe method for the surgical management of microspherophakia.展开更多
目的:对比25G玻璃体切割联合人工晶状体经睫状沟巩膜缝线固定术和无缝线巩膜隧道层间固定术治疗晶状体完全脱位的疗效。方法:回顾性病例对照研究。选取2015-05/2021-09在我院确诊为晶状体完全脱位于玻璃体腔的患者40例40眼,其中行25G玻...目的:对比25G玻璃体切割联合人工晶状体经睫状沟巩膜缝线固定术和无缝线巩膜隧道层间固定术治疗晶状体完全脱位的疗效。方法:回顾性病例对照研究。选取2015-05/2021-09在我院确诊为晶状体完全脱位于玻璃体腔的患者40例40眼,其中行25G玻璃体切割联合人工晶状体经睫状沟巩膜缝线固定术者21眼(缝线组),行25G玻璃体切割联合人工晶状体无缝线巩膜隧道层间固定术者19眼(无缝线组)。随访至术后3mo,观察两组患者手术时间、最佳矫正视力(BCVA)、角膜内皮细胞计数(CECC)、中央角膜厚度(CCT)及术后并发症情况。结果:无缝线组手术用时显著短于缝线组(31.79±6.01min vs 45.38±8.04min,P<0.001)。两组患者术后BCVA均较术前显著改善(均P<0.05),术后1wk无缝线组BCVA(LogMAR)显著优于缝线组(0.32±0.14 vs 0.57±0.25,P<0.001)。术后3mo,两组患者CECC均低于术前(均P<0.01)。缝线组术后1wk CCT大于术前和术后3mo(均P<0.01),无缝线组手术前后CCT无显著变化。随访期间,无缝线组并发症总发生率低于缝线组(26%vs 38%,P>0.05)。结论:25G玻璃体切割联合人工晶状体无缝线巩膜隧道层间固定术治疗晶状体完全脱位手术时间短,术后视力提升快,术后并发症少。展开更多
文摘Purpose: To develop a new technique for fixation of posterior chamber intraocular lens (IOL) in the absence of posterior capsule support.Materials and Methods: We performed non-trans-scleral fixation of intraocular lenses on 24 cases (24 eyes) without posterior capsule support. Two scleral flaps with limbal incisions and two peripheral iridectomies were made at 1 o' clock and 7 o' clock positions respectively. A suture-leading needle was used to lead the prolene suture from the limbal incision and iridectomy on one side through the iridectomy and limbal incision on the other side. Intraocular lens (IOL) was then fixed in the ciliary sulcus. Results: After a mean follow-up of 6. 6 months (range from 3 to 14 months), corrected visual acuity of 16 cases (16 eyes,66. 7% ) got 0.5 or better. Postoperative complications included discoria (4 eyes) , surface membrane formation ( 1 eye ), choroidal detachment (1 eye) and tilt of IOL (1 eyes),but all were not severe. Conclusion: In some situations such as low
基金Government Foundation of Liaoning Province, Shenyang,China(No.20081059,2008860)
文摘AIM: To study the impact of scleral flap position, under which the posterior chamber intraocular lenses (PC-IOL) were sulcus-fixed by trans-scleral suture, on cornea astigmatism. METHODS: Twenty-six aphakic or cataract eyes were comprised in this prospective noncomparative case series study. Eleven eyes had traumatic cataract removed without sufficient capsular support, 3 had blunt trauma with subluxated traumatic cataract, 8 had undergone vitreoretinal surgery and 4 had congenital cataract removed. The average age was 54 years (range 21-74 years), with 17 men and 7 women. The foldable PC-IOL was fixed in sulcus by trans-scleral suture. The incision for IOL implantation was made 1mm posterior to limbus along the steepest meridian of cornea, while scleral flaps to bury the knots of trans-scleral suture were made along the flattest meridian. All the surgeries were performed by a single doctor (Ma L), and the follow up was at least 13 months (range 13-28 months). The preoperative, 3 months and 1 year postoperative corneal curvature along the steepest and flattest cornea meridian and overall cornea astigmatism were compared. RESULTS: The curvature along the steepest meridian changed from 44.25 +/- 2.22D preoperatively to 44.08 +/- 2.16D at 3 months postoperatively, and 43.65 +/- 5.23D at 1 year postoperatively (P>0.05); the curvature along the flattest meridian changed from 41.24 +/- 2.21D preoperatively to 43.15 +/- 3.94D at 3 months postoperatively, and 42.85 +/- 5.17D at 1 year postoperatively (P<0.05); and the surgery induced astigmatism (SIA) on cornea was calculated by vector analysis, which was 2.42 +/- 2.13D at 3 months postoperatively, and 2.18 +/- 3.42D at 1 year postoperatively, the difference was statistically significant (P<0.05). CONCLUSION: The scleral flap made along the flattest meridian, under which the posterior chamber intraocular lenses (PCIOL) were sulcus-fixed by trans-scleral suture, can steepen the cornea in varying degrees, thus reducing preexisting corneal astigmatism.
文摘AIM:To evaluate the safety and efficacy of scleral-fixated 3-looped haptics intraocular lens(IOL)implantation for surgical management of microspherophakia.METHODS:A retrospective case series include 10 microspherophakic patients(15 eyes)who underwent lens removal plus a modified surgical treatment of scleral-fixated 3-looped haptics IOL implantation.The primary outcomes involved visual acuity,intraocular pressure(IOP).Secondary outcomes were spherical equivalent(SE),anterior chamber depth(ACD),corneal endothelial cell density and postoperative complications.RESULTS:After a postoperative follow-up of 17.60±15.44mo,improved visual outcomes can be observed.The uncorrected distance visual acuity(UCVA)log MAR improved from 1.54±0.59 preoperatively to 0.51±0.35 postoperatively(P=0.001),and best corrected visual acuity(BCVA)log MAR improved from 0.97±0.91 preoperatively to 0.24±0.23 postoperatively(P=0.003).Moreover,the SE decreased from-9.58±7.47D preoperatively to-0.65±2.21 D postoperatively(P<0.001).In terms of safety profile,the average IOP decreased from 21.10±12.94 mm Hg preoperatively to 14.03±3.57 mm Hg postoperatively(P=0.044),and the previously elevated IOP of three eyes decreased to the normal range.The ACD increased from 2.25±1.45 mm preoperatively to 3.35±0.39 mm postoperatively(P=0.017).The density of corneal endothelial cells did not change significantly after surgery(P=0.140).The posterior chamber IOLs were well centered and no severe complications were found.CONCLUSION:Lens removal plus the modified surgical treatment of scleral-fixated 3-looped haptics IOL implantation can help in improvement of visual acuity,which can be regarded as a relative safe method for the surgical management of microspherophakia.
文摘目的:对比25G玻璃体切割联合人工晶状体经睫状沟巩膜缝线固定术和无缝线巩膜隧道层间固定术治疗晶状体完全脱位的疗效。方法:回顾性病例对照研究。选取2015-05/2021-09在我院确诊为晶状体完全脱位于玻璃体腔的患者40例40眼,其中行25G玻璃体切割联合人工晶状体经睫状沟巩膜缝线固定术者21眼(缝线组),行25G玻璃体切割联合人工晶状体无缝线巩膜隧道层间固定术者19眼(无缝线组)。随访至术后3mo,观察两组患者手术时间、最佳矫正视力(BCVA)、角膜内皮细胞计数(CECC)、中央角膜厚度(CCT)及术后并发症情况。结果:无缝线组手术用时显著短于缝线组(31.79±6.01min vs 45.38±8.04min,P<0.001)。两组患者术后BCVA均较术前显著改善(均P<0.05),术后1wk无缝线组BCVA(LogMAR)显著优于缝线组(0.32±0.14 vs 0.57±0.25,P<0.001)。术后3mo,两组患者CECC均低于术前(均P<0.01)。缝线组术后1wk CCT大于术前和术后3mo(均P<0.01),无缝线组手术前后CCT无显著变化。随访期间,无缝线组并发症总发生率低于缝线组(26%vs 38%,P>0.05)。结论:25G玻璃体切割联合人工晶状体无缝线巩膜隧道层间固定术治疗晶状体完全脱位手术时间短,术后视力提升快,术后并发症少。
