Trans-scleral plugs fixated IOL: a new paradigm for sutureless scleral fixation
Trans-scleral plugs fixated IOL: a new paradigm for sutureless scleral fixation
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DOI：
10.1097/j.jcrs.0000000000000135
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发表时间：
2020-05-01
影响因子：
2.8
通讯作者：
Rizzo, Stanislao
中科院分区：
文献类型：
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作者：
Barca, Francesco;Caporossi, Tomaso;Rizzo, Stanislao
目的：评价一种新型单片式折叠式丙烯酸酯人工晶状体(Carlevale，Carlevale)无缝线巩膜固定术(SSF)的手术和屈光效果。单位：意大利佛罗伦萨大学卡雷吉分校眼科转化外科和医学系。设计：前瞻性观察病例系列。记录术前、术后屈光状态及术中、术后并发症。结果：人工晶状体/囊袋脱位22眼，无晶状体9眼，晶状体半脱位3眼。术前平均矫正远视力为最小分辨角对数(LogMAR)0.46+/-0.29，术后8个月平均矫正远视力为0.13+/-0.12logMAR(P<；0.05)，预测误差为-0.24+/-0.81屈光度(D)，人工晶体倾斜度为2.08+/-1.19度。1例(3.1%)患者出现一过性黄斑囊样水肿，1例(3.1%)患者发生玻璃体出血，2例(6.2%)眼色素弥散并伴有反转瞳孔阻塞。结论：新型人工晶状体SSF治疗无晶状体眼、晶状体半脱位及IOL袋复合脱位，具有独特的稳定性，是一种可行的方法。这项技术的优点是不需要触觉操作，自我集中，对人工晶状体的牢固固定。版权所有(C)2020由Wolters Kluwer代表ASCRS和ESCRS出版
Purpose: To assess the surgical and refractive outcomes of a new technique of sutureless scleral fixation (SSF) using a single-piece foldable acrylic intraocular lens (IOL) (Carlevale).Setting: Department of Translational Surgery and Medicine, Ophthalmology, University of Florence, Careggi, Florence, Italy.Design: Prospective observational case series.Methods: Thirty-two eyes of 32 patients with aphakia, dislocated IOL, or subluxated lens who underwent SSF with a novel single-piece hydrophilic acrylic IOL were studied. Preoperative and postoperative refractive status and complications during and after surgery were recorded. The IOL tilt was evaluated using anterior segment optical coherence tomography (AS-OCT).Results: Twenty-two eyes were IOL/bag luxations, 9 were aphakia, and 3 were subluxated crystalline lens. Mean pre-operative corrected distance visual acuity was 0.46 +/- 0.29 logarithm of the minimum angle of resolution (logMAR) and improved to 0.13 +/- 0.12 logMAR (P < .05) at the 8-month follow-up, with a predictive error spherical equivalent of -0.24 +/- 0.81 diopters (D); the IOL tilt was 2.08 +/- 1.19 degrees. One patient (3.1%) experienced transient cystoid macular edema, and 1 (3.1%) experienced vitreous hemorrhage; pigment dispersion with AS-OCT findings of reverse pupillary block was found in 2 (6.2%) eyes. IOL dislocation, conjunctival erosion, and plug externalization were not observed in any eye during the follow-up.Conclusions: SSF using the novel IOL could be a viable option for the management of aphakia, lens subluxation, and IOL-bag complex dislocation with unique characteristics of stability. The advantages of this technique were the absence of haptic manipulation, self-centration, and firm fixation of the IOL. Copyright (C) 2020 Published by Wolters Kluwer on behalf of ASCRS and ESCRS