巩膜固定与囊内人工晶状体有效晶状体位置及屈光效果的比较分析。

Clinical ophthalmology (Auckland, N.Z.) Pub Date : 2024-12-25 eCollection Date: 2024-01-01 DOI:10.2147/OPTH.S486044
Vichar Trivedi, Stacey Lee, Patrick S Y Lee, Rao Me, Qisheng You, Jacob Im, Bing Ross, David V Tran, Kim Hoang Le, Brett Malbin, Xihui Lin
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引用次数: 0

摘要

目的:评价采用Yamane技术或Gore-Tex缝线固定巩膜固定人工晶状体(iol)与囊内晶状体固定的效果,并评估不同晶状体配方在实现预测屈光目标方面的效果。患者和方法:本研究纳入44例巩膜固定人工晶状体患者45只眼,其中Yamane眼37只,Gore-Tex眼8只。术前各种公式的屈光预测比较了最终的术后屈光。评估的结果包括有效晶状体位置(ELP)、术后预测误差和视力变化。比较巩膜固定人工晶状体与囊内人工晶状体的ELP。结果:Yamane型人工晶状体比囊内型人工晶状体平均后移0.62 mm, Gore-Tex型人工晶状体无显著性差异。Yamane眼和Gore-Tex眼术后平均logMAR视力变化显著,分别为-1.30 (p=4.5x10-11)和-1.65 (p=5x10-4)。使用Barrett Universal II、Holladay、Hill-RBF和Hoffer QST公式,Yamane眼的平均预测误差分别为+0.29±1.3 D、-0.53±0.40 D、+0.80±1.4 D和+0.43±1.4 D。使用Barrett Universal II和Holladay公式,Gore-Tex眼的平均预测误差分别为-0.37±1.24 D和+0.53±1.19 D。结论:与囊内人工晶状体植入术相比,不同巩膜固定技术可导致ELP的变化。在我们看来,当使用Yamane技术时,外科医生在使用Barrett Universal II、Hill-RBF或Hoffer QST公式时,应以近视屈光目标为目标来抵消远视误差,而在使用Holladay公式时,应以远视目标为目标。对于Gore-Tex iol,在使用Barrett Universal II配方时,建议使用略微远视的目标值来抵消远视误差,而在使用Holladay配方时,建议使用略微近视的目标值来抵消远视误差。本研究的一个局限性是采用Gore-Tex缝合固定的患者样本量小。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparative Analysis of Effective Lens Position and Refractive Outcomes in Scleral-Fixated versus Intracapsular Intraocular Lenses.

Purpose: To evaluate the outcomes of scleral-fixated intraocular lenses (IOLs) implanted using either Yamane technique or Gore-Tex suture fixation, in comparison to intracapsular lens fixation, and to assess the efficacy of various lens formulas in achieving predicted refractive targets.

Patients and methods: This study included 45 eyes from 44 patients with scleral-fixated IOLs, comprising 37 Yamane eyes and 8 Gore-Tex eyes. Preoperative refractive predictions from various formulae were compared with final postoperative refraction. Outcomes assessed included effective lens position (ELP), postoperative predictive error, and changes in visual acuity. The ELP of scleral-fixated IOLs was compared with that of intracapsular IOLs in fellow eyes.

Results: Average ELP for Yamane IOLs was 0.62 mm more posterior relative to intracapsular IOLs but was not significantly different for Gore-Tex IOLs. Average postoperative logMAR acuity change was significant at -1.30 (p=4.5x10-11) and -1.65 (p=5x10-4) for Yamane and Gore-Tex eyes, respectively. Mean prediction error for Yamane eyes was +0.29±1.3 D, -0.53±0.40 D, +0.80±1.4 D, and +0.43±1.4 D using Barrett Universal II, Holladay, Hill-RBF, and Hoffer QST formulas, respectively. Mean prediction error for Gore-Tex eyes was -0.37±1.24 D and +0.53±1.19 D using Barrett Universal II and Holladay formulas, respectively.

Conclusion: Different scleral fixation techniques result in variations in ELP compared to intracapsular IOL placement. In our hands, when using the Yamane technique, surgeons should aim for a myopic refractive target to offset hyperopic errors when employing the Barrett Universal II, Hill-RBF, or Hoffer QST formulas, and a hyperopic target when using the Holladay formula. For Gore-Tex IOLs, a slightly hyperopic target is recommended to counter myopic error when using the Barrett Universal II formula, whereas a slightly myopic target is advised with the Holladay formula to offset hyperopic error. A limitation of our study is the small sample size for patients who underwent Gore-Tex suture fixation.

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