Comparison of Clinical Outcomes among Conventional Scleral Fixation, Retropupillary Iris-claw Intraocular Lens Implantation, and Intrascleral Fixation.

Q3 Medicine
Korean Journal of Ophthalmology : KJO Pub Date : 2022-10-01 Epub Date: 2022-08-19 DOI:10.3341/kjo.2022.0042
Min-Ji Kim, Gyu Le Han, Tae-Young Chung, Dong Hui Lim
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引用次数: 1

Abstract

Purpose: To compare the efficacy and safety of conventional scleral fixation (C-SF), retropupillary iris-claw intraocular lens (RP-IOL) implantation, and intrascleral fixation (ISF).

Methods: This retrospective observational study included 58 patients (58 eyes) who underwent C-SF (23 eyes), RP-IOL (23 eyes), and ISF (12 eyes) by a single surgeon at Samsung Medical Center from October 2017 to July 2020 and were followed up for at least 6 months. This study analyzed various clinical outcomes before surgery, and 1 day, 1 week, 1 month, 3 months, and 6 months after surgery.

Results: Six months after surgery, best-corrected visual acuity in logarithm of minimum angle of resolution was 0.08 ± 0.10, 0.08 ± 0.16, and 0.03 ± 0.04 in C-SF group, RP-IOL group, and ISF group, respectively, and there was a significant improvement in each group compared to preoperative best-corrected visual acuity. All groups showed a significant increase in astigmatism postoperatively, but no between-group differences were observed. The prediction error was -0.15 ± 0.77, 0.56 ± 0.62, and 0.44 ± 1.00 diopters in the three groups, respectively, indicating RP-IOL group and ISF group for hyperopic shift. The three groups did not differ in terms of absolute prediction error. Six months after surgery, the corneal endothelial cell counts were 2,073 ± 691, 2,014 ± 692, and 1,712 ± 891 cells/mm2, respectively, which were lower than before surgery. IOL dislocation occurred in five eyes only in RP-IOL group, two of which underwent two reoperations, and reenclavation was performed smoothly without complications in all cases.

Conclusions: Although the frequency of IOL dislocation in RP-IOL group was higher than that in the other groups, it can be reenclavated relatively easily. As a method of secondary IOL fixation, both RP-IOL implantation and ISF were as effective as conventional scleral fixation.

Abstract Image

Abstract Image

Abstract Image

常规巩膜内固定、瞳孔后虹膜爪式人工晶状体植入术和巩膜内固定的临床效果比较。
目的:比较常规巩膜内固定(C-SF)、瞳孔后虹膜-爪形人工晶状体(RP-IOL)植入术和巩膜内固定(ISF)的疗效和安全性。方法:本回顾性观察研究纳入了2017年10月至2020年7月在三星首尔医院由一名外科医生接受C-SF(23眼)、RP-IOL(23眼)和ISF(12眼)手术的58例(58眼)患者,随访至少6个月。本研究分析了术前、术后1天、1周、1个月、3个月、6个月的各项临床结果。结果:术后6个月,C-SF组、RP-IOL组、ISF组最佳矫正视力最小分辨角对数分别为0.08±0.10、0.08±0.16、0.03±0.04,均较术前最佳矫正视力有显著提高。各组患者术后散光明显增加,组间差异无统计学意义。三组预测误差分别为-0.15±0.77、0.56±0.62和0.44±1.00屈光度,提示RP-IOL组和ISF组存在远视移位。三组在绝对预测误差方面没有差异。术后6个月,角膜内皮细胞计数分别为2073±691个、2014±692个、1712±891个/mm2,均低于术前。RP-IOL组仅有5只眼发生人工晶状体脱位,其中2只眼进行了2次再手术,所有病例均顺利复位,无并发症。结论:RP-IOL组人工晶状体脱位发生率虽高于其他组,但相对容易复位。RP-IOL植入术和ISF作为二次人工晶状体的固定方法与常规巩膜固定一样有效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Korean Journal of Ophthalmology : KJO
Korean Journal of Ophthalmology : KJO Medicine-Ophthalmology
CiteScore
2.40
自引率
0.00%
发文量
84
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