Objective: To measure the clinical efficacy and safety of 25-G vitrectomy combined with transscleral intraocular lens (IOL) implantation. Methods: In this prospective study, patients (n=39, 39 eyes) without capsule support and experiencing lens dislocation, IOL dislocation, and aphakia were enrolled and treated with 25-G vitrectomy combined with transscleral IOL implantation. Differences in visual acuity, intraocular pressure (IOP), number of corneal endothelial cells, location of IOL, postoperative anatomic success, and the recurrence rate of IOL dislocation and complications were recorded. Data paired t-tests and repeated measured ANOVA. results: The average visual acuity (LogMARs) at 1 week, 1 month, 3 months, and 6 months after surgery were significantly differences improved compared with the pre-surgical values (P<0.05). The average IOPs at 1 week, 1 month, 3 months, and 6 months after operation were significantly ifferences lower compared with the pre-surgical values (P<0.05). One week after surgery, all of the implanted IOLs were in the correct position. One month after surgery, the IOLs in 36 eyes (92%) were in the correct position. The haptics of one IOL (3%) were exposed to the conjunctiva. Dislocation of two IOLs (5%) required alignment surgery at 3 and 6 months after insertion, positions of 36 IOLs were stable.conclusions: The 25-G vitrectomy combined with transscleral IOL implantation in the treatment of eyes without capsule support was effective and safe.
罗莎莎,张洁,丁楠楠,于津津,陈养浩,武志峰. 25G玻璃体切割联合IOL巩膜层间固定术的临床疗效[J]. 中华眼视光学与视觉科学杂志, 2018, 20(10): 622-626.
Shasha Luo,Jie Zhang,Nannan Ding,Jinjin Yu,Yanghao Chen,Zhifeng Wu. Effectiveness and Safety of 25-G Vitrectomy combined with transscleral Intraocular Lens Implantation in the treatment of complex cataract. Chinese Journal of Optometry Ophthalmology and Visual science, 2018, 20(10): 622-626. DOI: 10.3760/cma.j.issn.1674-845X.2018.10.010
Suelves AM, Kruh JN, Aznar-Peña I, et al. Long-term safety and visual outcomes of anterior chamber intraocular lens implantation in patients with a history of chronic uveitis. J
Ong HS, Subash M, Adams GG. Spontaneous subluxation of iris-claw aphakic intraocular lens causing complications in two children. J Pediatr Ophthalmol Strabismus, 2012, 49 Online:e55-58. DOI: 10.3928/01913913-20121002-02.
[2]
Suelves AM, Kruh JN, Aznar-Peña I, et al. Long-term safety and visual outcomes of anterior chamber intraocular lens implantation in patients with a history of chronic uveitis. J
Ong HS, Subash M, Adams GG. Spontaneous subluxation of iris-claw aphakic intraocular lens causing complications in two children. J Pediatr Ophthalmol Strabismus, 2012, 49 Online:e55-58. DOI: 10.3928/01913913-20121002-02.
[4]
Maggi R, Maggi C. Sutureless scleral fixation of intraocular lenses. J Cataract Refract Surg, 1997, 23(9): 1289-1294.
[5]
Agarwal A, Kumar DA, Jacob S, et al. Fibrin glue-assisted sutureless posterior chamber intraocular lens implantation in eyes with deficient posterior capsules. J Cataract Refract Surg,2008, 34(9): 1433-1438. DOI: 10.1016/j.jcrs.2008.04.040.
[6]
Saleh M, Heitz A, Bourcier T, et al. Sutureless intrascleral intraocular lens implantation after ocular trauma. J Cataract Refract Surg, 2013, 39(1): 81-86. DOI: 10.1016/j.jcrs.2012.08.
[4]
Maggi R, Maggi C. Sutureless scleral fixation of intraocular lenses. J Cataract Refract Surg, 1997, 23(9): 1289-1294.
[5]
Agarwal A, Kumar DA, Jacob S, et al. Fibrin glue-assisted sutureless posterior chamber intraocular lens implantation in eyes with deficient posterior capsules. J Cataract Refract Surg,2008, 34(9): 1433-1438. DOI: 10.1016/j.jcrs.2008.04.040.
[6]
Saleh M, Heitz A, Bourcier T, et al. Sutureless intrascleral intraocular lens implantation after ocular trauma. J Cataract Refract Surg, 2013, 39(1): 81-86. DOI: 10.1016/j.jcrs.2012.08.
063.
[7]
Karadag R, Bayramlar H, Yamane et al. Sutureless 27-gauge needle-guided intrascleral intraocular lens implantation with lamellar scleral dissection. Ophthalmology, 2014, 121(8): e42.DOI: 10.1016/j.ophtha.2014.03.019.
[8]
Ohta T, Toshida H, Murakami A. Simplified and safe method of sutureless intrascleral posterior chamber intraocular lens fixation: Y-fixation technique. J Cataract Refract Surg, 2014,40(1): 2-7. DOI: 10.1016/j.jcrs.2013.11.003.
[9]
Agarwal A, Jacob S, Kumar DA, et al. Handshake techniquefor glued intrascleral haptic fixation of a posterior chamber intraocular lens. J Cataract Refract Surg, 2013, 39(3): 317-322.DOI: 10.1016/j.jcrs.2013.01.019.
063.
[7]
Karadag R, Bayramlar H, Yamane et al. Sutureless 27-gauge needle-guided intrascleral intraocular lens implantation with lamellar scleral dissection. Ophthalmology, 2014, 121(8): e42.DOI: 10.1016/j.ophtha.2014.03.019.
[8]
Ohta T, Toshida H, Murakami A. Simplified and safe method of sutureless intrascleral posterior chamber intraocular lens fixation: Y-fixation technique. J Cataract Refract Surg, 2014,40(1): 2-7. DOI: 10.1016/j.jcrs.2013.11.003.
[9]
Agarwal A, Jacob S, Kumar DA, et al. Handshake techniquefor glued intrascleral haptic fixation of a posterior chamber intraocular lens. J Cataract Refract Surg, 2013, 39(3): 317-322.DOI: 10.1016/j.jcrs.2013.01.019.
[10]
Holladay JT. Proper method for calculating average visual acuity. J Refract Surg, 1997, 13(4): 388-391.
[11]
Kumar DA, Agarwal A, Packiyalakshmi S, et al. Complications and visual outcomes after glued foldable intraocular lens implantation in eyes with inadequate capsules. J Cataract Refract Surg, 2013, 39(8): 1211-1218. DOI: 10.1016/j.jcrs.2013.03.004.
[12]
Matsui Y, Matsubara H, Hanemoto T, et al. Exposure of haptic of posterior chamber intraocular lens after sutureless intrascleral fixation. BMC Ophthalmol, 2015, 15: 104. DOI: 10.1186/s12886-015-0102-3.
[13]
Takayama K, Akimoto M, Taguchi H, et al. Transconjunctival sutureless intrascleral intraocular lens fixation using intrascleral tunnels guided with catheter and 30-gauge needles. Br J Ophthalmol, 2015, 99(11): 1457-1459. DOI: 10.1136/bjophthalmol-2014-306579.
[14]
Akimoto M, Taguchi H, Takayama K, et al. Intrascleral fixation technique using catheter needles and 30-gauge ultrathin needles:lock-and-lead technique. J Cataract Refract Surg, 2015, 41(2):257-261. DOI: 10.1016/j.jcrs.2014.08.030.
[15]
Yamane S, Sato S, Maruyama-Inoue M, et al. Flanged intrascleral intraocular lens fixation with double-needle technique. Ophthalmology, 2017, 124(8): 1136-1142. DOI:10.1016/j.ophtha.2017.03.036.
Holladay JT. Proper method for calculating average visual acuity. J Refract Surg, 1997, 13(4): 388-391.
[11]
Kumar DA, Agarwal A, Packiyalakshmi S, et al. Complications and visual outcomes after glued foldable intraocular lens implantation in eyes with inadequate capsules. J Cataract Refract Surg, 2013, 39(8): 1211-1218. DOI: 10.1016/j.jcrs.2013.03.004.
[12]
Matsui Y, Matsubara H, Hanemoto T, et al. Exposure of haptic of posterior chamber intraocular lens after sutureless intrascleral fixation. BMC Ophthalmol, 2015, 15: 104. DOI: 10.1186/s12886-015-0102-3.
[13]
Takayama K, Akimoto M, Taguchi H, et al. Transconjunctival sutureless intrascleral intraocular lens fixation using intrascleral tunnels guided with catheter and 30-gauge needles. Br J Ophthalmol, 2015, 99(11): 1457-1459. DOI: 10.1136/bjophthalmol-2014-306579.
[14]
Akimoto M, Taguchi H, Takayama K, et al. Intrascleral fixation technique using catheter needles and 30-gauge ultrathin needles:lock-and-lead technique. J Cataract Refract Surg, 2015, 41(2):257-261. DOI: 10.1016/j.jcrs.2014.08.030.
[15]
Yamane S, Sato S, Maruyama-Inoue M, et al. Flanged intrascleral intraocular lens fixation with double-needle technique. Ophthalmology, 2017, 124(8): 1136-1142. DOI:10.1016/j.ophtha.2017.03.036.