背景:将人工晶状体植入囊袋已成为无晶状体状态下的护理标准。然而,在没有囊支持的情况下,几种技术和人工晶状体是可用的。我们的研究旨在报告安全性,功效,采用Yamane双针技术和带凸缘的经结膜巩膜人工晶状体固定术的临床结果。
方法:前瞻性,观察性研究,并收集一些回顾性数据。该研究纳入了2017年6月至2019年4月在达兰眼科专科医院和法赫德国王大学医院接受Yamane技术经结膜巩膜内固定人工晶状体的13例患者(16眼)。所有患者均行术前、术后综合评估,包括未矫正和最佳矫正视力,眼内压,裂隙灯检查,扩张眼底检查,和超声生物显微镜。我们排除了视觉上有意义的共存病理如视网膜疾病的患者,青光眼,随访不到三个月,联合手术如角膜移植术.
结果:术前平均未矫正视力为1.50logMAR,并提高到0.60logMAR。术前平均最佳矫正视力为0.70logMAR,它提高到0.40logMAR。安全性指数中位数为2.0,疗效指数中位数为1.58。术后并发症包括单眼人工晶状体捕获虹膜(7.7%),一只眼睛的触觉挤压(7.7%),一只眼睛的一过性角膜水肿(7.7%)。术后视网膜脱离随访期间未检出报告,脉络膜脱离,眼内压升高(>25mmHg),矮个子,前房积血,玻璃体出血,或眼内炎。
结论:经结膜巩膜内固定人工晶状体安全有效,学习曲线短,与术中或术后并发症无关。
BACKGROUND: Implantation of intraocular lens in the capsular bag has become the standard of care in aphakic state. However, in the absence of capsular support, several techniques and intraocular lenses are available. Our study aims to report the safety, efficacy, and clinical outcomes of transconjunctival intrascleral intraocular lens fixation with Yamane\'s double-needle technique and flanged haptics.
METHODS: Prospective, observational study with some retrospective data collection. The study enrolled 13 patients (16 eyes) who underwent transconjunctival intrascleral fixation of an intraocular lens with Yamane\'s technique between June 2017 and April 2019 at Dhahran Eye Specialist Hospital and King Fahd University Hospital. All patients underwent preoperative and postoperative comprehensive evaluation, including uncorrected and best-corrected vision, intraocular pressure, slit-lamp examination, dilated fundus examination, and ultrasound biomicroscopy. We excluded patients with visually significant coexistent pathology such as retinal diseases, glaucoma, follow-up less than three months, and combined surgery such as keratoplasty.
RESULTS: The mean preoperative uncorrected visual acuity was 1.50 logMAR, and it improved to 0.60 logMAR. The mean preoperative best-corrected visual acuity was 0.70 logMAR, and it improved to 0.40 logMAR. The median safety index was 2.0, and the median efficacy index was 1.58. The postoperative complications included iris capture by the intraocular lens in one eye (7.7%), haptic extrusion in one eye (7.7%), and transient cornea edema in one eye (7.7%). There were no detected reports during the follow-up period of postoperative retinal detachment, choroidal detachment, elevation of the intraocular pressure (> 25 mmHg), hypotony, hyphema, vitreous hemorrhage, or endophthalmitis.
CONCLUSIONS: The transconjunctival intrascleral fixation of an intraocular lens is safe and effective with a short learning curve and was not associated with significant intraoperative or postoperative complications.