一种改良微创人工晶状体固定术的临床观察

Clinical observation of a modified minimally invasive intraocular lens fixation surgery

摘要:

目的：观察隐形锚钩式巩膜层间人工晶状体固定术的临床效果。

方法：前瞻性非对照性病例研究。选取2019-01/2020-12我院收治的无晶状体、人工晶状体脱位或晶状体脱位患者19例19眼，所有患者均接受锚钩式人工晶状体巩膜层间固定植入手术。观察手术前后最佳矫正视力(BCVA)、裸眼视力(UCVA)、角膜内皮细胞密度、术后人工晶状体位置有无倾斜和并发症。

结果：术前和术后1 mo ，UCVA(LogMAR)为1.06±0.63和0.40±0.26(P<0.01)，BCVA(LogMAR)为0.27±0.51和0.06±0.15(P=0.09)，角膜内皮细胞密度为2406±625和2004±759 cells/mm²(P=0.13)。术后1d房水闪辉2级或以上3眼，角膜后弹力层皱褶2眼，一过性眼压升高2眼。随访24 mo均未发生人工晶状体脱位。

结论：锚钩式人工晶状体巩膜层间固定技术，组织间线头顺行进入-逆向固定，类似锚钩原理，达到了良好的人工晶状体稳定性和视觉效果。

Abstract:

AIM: To observe the clinical effect of invisible anchor hook intraocular lens(IOL)fixation surgery.

METHODS: Prospective and uncontrolled case study. A total of 19 patients(19 eyes)with aphakia, IOL dislocation, or lens dislocation from January 2019 to December 2020 were selected for this study, all of whom underwent anchor hook IOL scleral fixation implantation surgery. The main postoperative observation indicators are best corrected visual acuity(BCVA), uncorrected visual acuity(UCVA), corneal endothelial cell density, tilt of IOL position, and complications.

RESULTS: The UCVA(LogMAR)before and at 1 mo after surgery was 1.06±0.63 and 0.40±0.26, respectively(P<0.01), BCVA(LogMAR)before and at 1 mo after surgery was 0.27±0.51 and 0.06±0.15, respectively(P=0.09), and the average corneal endothelial cell density was 2406±625 and 2004±759 cells/mm²(P=0.13). The complications that occurred at 1 d postoperatively were 2 and higher grade aqueous flare(3 eyes), wrinkling of the corneal posterior elastic layer(2 eyes), and transient elevated intraocular pressure(2 eyes). No IOL dislocation occurred during 24 mo follow-up.

CONCLUSION:The anchor hook type IOL scleral interlayer fixation technique, which involves anterograde insertion and retrograde fixation of the interstitial thread, is similar to the principle of anchor hook and achieves good IOL stability and visual effects.