Long-term results of late “in-the-bag” IOL dislocation surgery

IF 0.9 Q4 OPHTHALMOLOGY
Vitaliy V. Potemkin, S. Astakhov, T. S. Varganova, Xin Eric Wang, Liliia K. Anikina, S. E. Babaeva
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Abstract

BACKGROUND: Intraocular lens (IOL) repositioning and IOL exchange are the main methods of surgical treatment of late in-the-bag IOL dislocation. AIM: To evaluate refraction, induced corneal astigmatism and IOL tilt after surgical treatment of late in-the-bag IOL dislocation by transscleral suture fixation and exchange to iris-claw IOL with retropupillary fixation. MATERIALS AND METHODS: 78 of patients with late in-the-bag IOL dislocation were included. Transscleral suture IOL fixation was performed in group I (38 eyes), exchange to iris-claw IOL was performed in group II (40 eyes). Refractometry, keratotopography and optical coherence tomography of anterior segment were performed before surgery, 1 week, 1, 3 and 6 months after surgery. RESULTS: The groups did not differ in subjective and objective refraction. But there was significant variability of data in the group I 3 and 6 months after surgery. There was no difference in corneal astigmatism in both groups during 3 months, but a significant increase was found in group II 6 months after surgery. There was no difference in IOL tilt between groups before surgery. Decrease of IOL tilt in 180 degrees plane was observed after 1 month in group II, while there was no difference in 90 degrees plane between groups. CONCLUSIONS: Both methods of late in-the-bag IOL dislocation treatment allow to receive good refractive result, but refraction is less predictable after trans-scleral suture IOL fixation. Surgically induced astigmatism is higher in IOL exchange group due to large sclerocorneal tunnel incision. Transscleral suture IOL fixation does not cause clinically significant IOL tilt.
晚期“袋式”人工晶状体脱位手术的远期疗效
背景:人工晶状体重新定位和人工晶状体置换术是手术治疗晚期袋式人工晶状体脱位的主要方法。目的:观察经巩膜缝合固定置换虹膜-爪形人工晶状体瞳孔后固定治疗晚期袋内人工晶状体脱位术后的屈光、角膜散光及人工晶状体倾斜情况。材料与方法:78例晚期袋内人工晶状体脱位患者。I组(38眼)行经巩膜缝合人工晶状体固定,II组(40眼)行虹膜-爪式人工晶状体置换。术前、术后1周、1月、3月、6月分别行角膜前段折射、角膜地形图、光学相干断层扫描。结果:两组主客观屈光度无明显差异。但I组术后3个月和6个月的数据存在显著差异。术后3个月,两组患者角膜散光无明显差异,术后6个月,两组患者角膜散光明显增加。术前两组人工晶状体倾斜度无差异。1个月后,组内人工晶状体在180度平面上的倾斜度下降,组间在90度平面上的倾斜度无差异。结论:两种方法均可获得良好的屈光效果,但经巩膜缝合人工晶状体固定后屈光难以预测。人工晶状体交换组由于角膜硬化隧道切口较大,手术致散光较高。经巩膜缝合人工晶状体固定不会引起临床上明显的人工晶状体倾斜。
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来源期刊
Current Ophthalmology Reports
Current Ophthalmology Reports Medicine-Ophthalmology
CiteScore
2.00
自引率
0.00%
发文量
22
期刊介绍: This journal aims to offer expert review articles on the most significant recent developments in the field of ophthalmology. By providing clear, insightful, balanced contributions, the journal intends to serve those who diagnose, treat, manage, and prevent ocular conditions and diseases. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas across the field. Section Editors select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An Editorial Board of more than 20 internationally diverse members reviews the annual table of contents, ensures that topics include emerging research, and suggests topics of special importance to their country/region. Topics covered may include age-related macular degeneration; diabetic retinopathy; dry eye syndrome; glaucoma; pediatric ophthalmology; ocular infections; refractive surgery; and stem cell therapy.
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