PDF(Pubmed)
Abstract：
OBJECTIVE: The purpose of the study was to report the complications of sutureless intrascleral (SIS) intraocular lens (IOL) fixation and its management.
METHODS: A multicenter, retrospective, consecutive interventional case series of patients with intra or postoperative complications after SIS IOL fixation during the technical learning curve of vitreoretinal surgeons from three Taiwanese referral hospitals. The used surgical techniques were the Scharioth technique for intrascleral tunnel fixation, Yamane technique (double-needle scleral fixation), and modified Yamane technique (double-needle flanged haptic scleral fixation). The IOL models and surgical instruments used as well as each patient\'s ocular characteristics and complication management were recorded.
RESULTS: Of the eight included patients, the complications of 3 (37.5%) and 5 (62.5%) were noted intraoperatively and postoperatively, respectively. Haptic-related complications, including haptic breakage, slippage, and haptic disinsertion, occurred in six eyes. Other complications included uveitis-glaucoma-hyphema syndrome, retinal detachment, and IOL tilt. For the two patients with haptic slippage, repositioning was achieved using a modified cow-hitch technique that resulted in favorable IOL centration and restored visual acuity.
CONCLUSIONS: Most complications surgeons encountered during their early exposure to SIS IOL fixation were haptic related. Surgeons should be aware of such complications to prevent and manage them during surgery. Our modified cow-hitch technique could be used to reposition IOLs with unilateral haptic slippage.
METHODS: A multicenter, retrospective, consecutive interventional case series of patients with intra or postoperative complications after SIS IOL fixation during the technical learning curve of vitreoretinal surgeons from three Taiwanese referral hospitals. The used surgical techniques were the Scharioth technique for intrascleral tunnel fixation, Yamane technique (double-needle scleral fixation), and modified Yamane technique (double-needle flanged haptic scleral fixation). The IOL models and surgical instruments used as well as each patient\'s ocular characteristics and complication management were recorded.
RESULTS: Of the eight included patients, the complications of 3 (37.5%) and 5 (62.5%) were noted intraoperatively and postoperatively, respectively. Haptic-related complications, including haptic breakage, slippage, and haptic disinsertion, occurred in six eyes. Other complications included uveitis-glaucoma-hyphema syndrome, retinal detachment, and IOL tilt. For the two patients with haptic slippage, repositioning was achieved using a modified cow-hitch technique that resulted in favorable IOL centration and restored visual acuity.
CONCLUSIONS: Most complications surgeons encountered during their early exposure to SIS IOL fixation were haptic related. Surgeons should be aware of such complications to prevent and manage them during surgery. Our modified cow-hitch technique could be used to reposition IOLs with unilateral haptic slippage.
摘要：
目的：本研究的目的是报告无缝线巩膜内（SIS）人工晶状体（IOL）固定的并发症及其处理方法。
方法：多中心，回顾性,在三家台湾转诊医院的玻璃体视网膜外科医生的技术学习曲线期间，SISIOL固定术后出现术中或术后并发症的连续介入病例系列。所使用的手术技术是用于巩膜内隧道固定的Scharioth技术，Yamane技术（双针巩膜固定），和改良的Yamane技术（双针法兰触觉巩膜固定）。记录使用的IOL模型和手术器械以及每位患者的眼部特征和并发症处理。
结果：在纳入的8名患者中，术中、术后并发症分别为3例(37.5%)和5例(62.5%),分别。触觉相关并发症,包括触觉断裂，打滑,和触觉脱插，发生在六只眼睛里。其他并发症包括葡萄膜炎-青光眼-前房积血综合征，视网膜脱离,和IOL倾斜。对于两名触觉打滑的患者，使用改良的牛挂接技术实现了重新定位，从而实现了良好的IOL集中并恢复了视力。
结论：外科医生在早期暴露于SISIOL固定过程中遇到的大多数并发症与触觉相关。外科医生应该意识到这些并发症，以预防和管理手术期间的并发症。我们改进的牛挂接技术可用于在单侧触觉滑移的情况下重新定位IOL。
方法：多中心，回顾性,在三家台湾转诊医院的玻璃体视网膜外科医生的技术学习曲线期间，SISIOL固定术后出现术中或术后并发症的连续介入病例系列。所使用的手术技术是用于巩膜内隧道固定的Scharioth技术，Yamane技术（双针巩膜固定），和改良的Yamane技术（双针法兰触觉巩膜固定）。记录使用的IOL模型和手术器械以及每位患者的眼部特征和并发症处理。
结果：在纳入的8名患者中，术中、术后并发症分别为3例(37.5%)和5例(62.5%),分别。触觉相关并发症,包括触觉断裂，打滑,和触觉脱插，发生在六只眼睛里。其他并发症包括葡萄膜炎-青光眼-前房积血综合征，视网膜脱离,和IOL倾斜。对于两名触觉打滑的患者，使用改良的牛挂接技术实现了重新定位，从而实现了良好的IOL集中并恢复了视力。
结论：外科医生在早期暴露于SISIOL固定过程中遇到的大多数并发症与触觉相关。外科医生应该意识到这些并发症，以预防和管理手术期间的并发症。我们改进的牛挂接技术可用于在单侧触觉滑移的情况下重新定位IOL。
