目的:评价包膜张力环和包膜钩(CTR-CH)植入治疗马凡氏综合征(MFS)伴扁桃体外翻(EL)患者的安全性和有效性。
方法:复旦大学附属眼科耳鼻喉科医院.
方法:回顾性倾向评分匹配队列研究。
方法:本研究包括在CTR-CH或改良囊张力环(MCTR)辅助下进行袋内人工晶状体(IOL)植入的MFS患者。安全性分析的重点是再手术率。疗效分析比较了最佳矫正视力(BCVA)和倾向评分匹配(PSM)后激光囊切开术的发生率。
结果:本研究包括148只行CTR-CH手术的眼和162只行MCTR植入的眼。在CTR-CH组中,手术时的中位年龄为5岁,平均随访时间为1.81±0.4年。5只眼(3.38%)因视网膜脱离需要第二次手术(2,1.35%),IOL偏心(2,1.35%),和CH位错(1,0.68%)。再次手术率与MCTR组相当(P=0.486)。PSM之后,每组共招募108例患者.两组术后BCVA均显著改善(均P<0.001),但组间具有可比性(P=0.057)。后囊混浊发生较早(P=0.046),与MCTR组相比,前囊混浊需要激光囊切开术(P=0.037)。
结论:CTR-CH程序是可行的,安全,以及管理MFS患者EL的有效方法。
OBJECTIVE: To evaluate the safety and efficacy of capsular tension ring and capsular hook (CTR-CH) implantation in Marfan syndrome (MFS) patients with ectopia lentis (EL).
METHODS: Eye and ENT Hospital of Fudan University, Shanghai,
China.
METHODS: Retrospective propensity score-matched cohort study.
METHODS: This study included patients with MFS who had in-the-bag intraocular lens (IOL) implantation assisted by CTR-CH or modified CTR (MCTR). The safety analysis focused on the resurgery rate. The efficacy analysis compared the corrected distance visual acuity (CDVA) and the incidence of laser capsulotomy after propensity score matching (PSM).
RESULTS: This study encompassed 148 eyes that had the CTR-CH procedure and 162 eyes that received MCTR implantation. In the CTR-CH group, the median age at the time of surgery was 5 years, with a mean follow-up duration of 1.81 ± 0.4 years. 5 eyes (3.38%) required a second surgery because of retinal detachment (2, 1.35%), IOL decentration (2, 1.35%), and CH dislocation (1, 0.68%). The resurgery rate was comparable with that of the MCTR group ( P = .486). After PSM, a total of 108 eyes were recruited in each group. Postoperative CDVA was significantly improved in both groups (both P < .001), but comparable between the groups ( P = .057). The posterior capsular opacification took place earlier ( P = .046) while the anterior capsular opacification required laser capsulotomy at a later stage ( P = .037) compared with the MCTR group.
CONCLUSIONS: The CTR-CH procedure was a feasible, safe, and efficient approach for managing EL in patients with MFS.