METHODS: Consecutive patients who underwent secondary IOL insertion at a tertiary care academic hospital using either modified glued (\"glued\") or flanged intrascleral haptic fixation (FISHF) techniques with over 12 months of follow-up were retrospectively reviewed. Pre- and postoperative corrected distance visual acuity (CDVA), postoperative complications, and refractive surprises were reported.
RESULTS: Thirty-eight patients underwent \"glued\" fixation and 22 underwent FISHF, with mean follow-up times of 3.1 ± 0.5 and 2.0 ± 1.2 years, respectively. Aphakia secondary to trauma was the main surgical indication. MA50BM or MA60AC IOLs (Alcon Laboratories Inc., Fort Worth, TX) were implanted in 92% of \"glued\" patients, while CT Lucia 602 IOLs (Carl Zeiss Meditec Inc., Dublin, CA) were used in 96% of FISHF patients. Postoperative spherical equivalent significantly improved compared to preoperative values (p < 0.001). No significant difference in CDVA was seen between the two techniques. FISHF resulted in mean hyperopic surprises of + 0.81D and + 0.69D using the Holladay 2 and Barrett Universal II formulae, respectively, which was significantly greater than the \"glued\" patients. A higher rate of IOL dislocation was seen in the \"glued\" cohort (13%) compared to FISHF (0%).
CONCLUSIONS: Retrospective long-term outcomes of patients with complex ocular comorbidities undergoing a modified \"glued\" technique demonstrated a higher rate of IOL dislocation but more predictable refractive outcomes compared to the FISHF technique. The FISHF technique resulted in a significant hyperopic shift using fourth-generation IOL calculators.
方法:回顾性分析了在三级护理学术医院使用改良胶合(“胶合”)或法兰巩膜内触觉固定(FISHF)技术进行二次IOL插入并随访超过12个月的患者。术前术后矫正视力(CDVA),术后并发症,据报道,屈光令人惊讶。
结果:38名患者接受了“胶合”固定,22名患者接受了FISHF,平均随访时间为3.1±0.5和2.0±1.2年,分别。外伤继发的无晶状体眼是主要的手术指征。MA50BM或MA60ACIOL(爱尔康实验室有限公司,沃思堡,TX)被植入92%的“胶粘”患者中,而CTLucia602IOL(CarlZeissMeditecInc.,都柏林,CA)用于96%的FISHF患者。术后球面当量较术前值显著改良(p<0.001)。两种技术之间的CDVA没有显着差异。使用Holladay2和BarrettUniversalII公式,FISHF导致平均远视惊喜为0.81D和0.69D,分别,显着大于“胶粘”患者。与FISHF(0%)相比,在“胶合”队列(13%)中观察到更高的IOL脱位率。
结论:回顾性长期结果与FISHF技术相比,接受改良“胶合”技术的复杂眼合并症患者显示出更高的IOL脱位率,但更可预测的屈光结果。FISHF技术使用第四代IOL计算器导致明显的远视偏移。