METHODS: Five patients with aphakia and traumatic mydriasis were operated on by the same surgeon. All patients underwent sutureless intrascleral IOL fixation combined with modified iris cerclage pupilloplasty and were followed up for ≥6 months. Best-corrected visual acuity (BCVA) was measured using the logarithm of the minimum angle of resolution (logMAR). BCVA, intraocular pressure (IOP), pupil diameter, and corneal endothelial cell count (CECC) preoperatively and postoperatively were statistically analyzed. The pupil shape, photophobia, IOL position, and surgical complications were evaluated.
RESULTS: The mean BCVA was significantly improved 6 months postoperatively (0.26 ± 0.17 logMAR, P = 0.042) than preoperatively (0.50 ± 0.30 logMAR). No significant difference was observed between the preoperative and postoperative IOP (P = 0.138). The mean pupil diameter significantly reduced postoperatively than preoperatively (3.44 ± 0.35 mm vs. 7.28 ± 0.35 mm, P = 0.043). There was no significant decrease in CECC postoperatively (P = 0.225). The pupil shape was round-like, and photophobia disappeared in all patients. No intraoperative or postoperative complications occurred.
CONCLUSIONS: Sutureless intrascleral IOL fixation combined with modified iris cerclage pupilloplasty is a safe and efficient procedure for treating aphakia traumatic mydriasis patients without sufficient capsular support.
方法:同一位外科医生对5例无晶状体眼和外伤性散瞳患者进行手术。所有患者均行无缝线巩膜内人工晶状体固定术联合改良虹膜环扎术,随访≥6个月。使用最小分辨率角(logMAR)的对数测量最佳矫正视力(BCVA)。BCVA,眼内压(IOP),瞳孔直径,术前、术后角膜内皮细胞计数(CECC)进行统计学分析。瞳孔形状,畏光,IOL位置,并对手术并发症进行了评估。
结果:术后6个月平均BCVA明显改善(0.26±0.17logMAR,P=0.042)比术前(0.50±0.30logMAR)。术前、术后眼压差异无统计学意义(P=0.138)。术后平均瞳孔直径较术前显著减小(3.44±0.35mmvs.7.28±0.35mm,P=0.043)。术后CECC无明显下降(P=0.225)。瞳孔形状是圆形的,所有患者畏光消失。术中、术后无并发症发生。
结论:无Sutueless巩膜内人工晶状体内固定联合改良虹膜环扎术瞳孔成形术是治疗无晶状体外伤性散瞳患者的安全有效的方法。