目的:评估巩膜缝合人工晶状体(IOL)的长期稳定性,并分析缝合线断裂的可能原因。
巴塞罗那的BarraquerInstitute,西班牙。
连续病例的回顾性研究。
巩膜缝合人工晶状体伴无晶状体眼患者的研究,包括半脱位或脱位IOL.随访时间超过6个月,患者年龄超过18岁。术前数据(最佳矫正视力测试(BCVA),眼内压(IOP),轴向长度和裂隙灯检查),术中数据(巩膜皮瓣的特征,缝合材料(Prolene或Mersilene)和巩膜缝合IOL)和术后数据(BCVA,IOP,收集裂隙灯检查和并发症)通过10年进行分析。
共纳入345例连续巩膜缝合人工晶状体。25只眼由于缝线断裂而在先前缝合的IOL后进行了第二次手术(第一次手术后平均40.2±39.6个月),其中3只需要进行第三次手术。年轻人(40岁以下),在10年的随访后,发现使用Prolene和Mersilene缝线联合进行手术并仅缝合一个皮瓣的缝线断裂风险较高.巩膜缝合IOL术后10年存活概率为0.79。
在缺乏囊支持的情况下,巩膜缝合后房型人工晶状体是一种安全有效的手术,并发症发生率低,视力稳定。需要特别关注年轻人或近视眼的进一步研究,以证明在这些特殊情况下的长期安全性。
Purpose: To evaluate the long-term stability of scleral-sutured intraocular lenses (IOLs) and analyse the possible causes of suture breakage.
Barraquer Institute in Barcelona, Spain.
Retrospective study of consecutive cases.
Study of patients with scleral-sutured IOL with aphakia, subluxated or luxated IOL were included. Follow-up was longer than 6 months and patients over 18 years of age. Preoperative data (best-corrected visual acuity testing (BCVA), intraocular pressure (IOP), axial length and slit-lamp examination), intraoperative data (characteristics of the scleral flaps, suture material (Prolene or Mersilene) and scleral-sutured IOL) and postoperative data (BCVA, IOP, slit-lamp examination and complications) through 10 years were collected for analysis.
345 consecutive cases of scleral-sutured IOL were included. 25 eyes underwent a second operation after a prior sutured IOL due to suture breakage (mean 40.2±39.6 months after the first surgery) and three of them needed a third surgery. Younger adults (less than 40-year old), the use of a combination of Prolene and Mersilene sutures to perform the surgery and suturing only one flap were found to have higher risk of suture breakage after a follow-up of 10 years. The probability of surviving of the scleral-sutured IOL at 10 years after surgery was 0.79.
Scleral-sutured posterior chamber IOL in eyes with a lack of capsular support is a safe and effective procedure with a low rate of complication and stable visual acuity. Further studies with special focus on young adults or myopic eyes are required to demonstrate long-term safety in those special cases.