Comparison of outcomes of two intraocular lens implantation procedures for aphakic eyes without capsular support / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To compare the curative effect of retropupillary iris claw intraocular lens(IOL)implantation and posterior chamber ciliary scleral suture fixed IOL in the aphakic eyes without capsular support.<p>METHODS: The present retrospective study included 70 aphakic eyes without capsular support. According to the different surgical methods, the patients were divided into two groups, including group A(35 eyes)with treatment of retropupillary iris claw IOL implantation, group B(35 eyes)with treatment of posterior chamber ciliary scleral suture fixed IOL. The uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), intraocular pressure(IOP)and corneal endothelial cell density(CECD)of the two groups were documented and compared before operation and 3d, 1, 3, 6mo and 1a after operation. Furthermore, the stability of IOL in both groups, as well as the intraoperative and postoperative complications were recorded.<p>RESULTS: The patients in the present study were followed up for 12 to 14mo. 3d after surgery, UCVA in group A was significantly improved compared with that before surgery(<i>P</i><0.01), while BCVA had no difference compared with that before surgery(<i>P</i>=0.073).UCVA in group B showed no difference(<i>P</i>=0.097), while BCVA was worse(<i>P</i>=0.002). UCVA and BCVA in both groups were significantly elevated 1mo after surgery(<i>P</i><0.05), and remained stable 6, 3mo later,respectively. Furthermore, IOP in both groups remained in normal level during the follow up period, 0.7% and 2.3% reduction of CECD in A group and B gruop was observed at 1a after operation respectively(<i>P</i><0.05). Both IOP and CECD between the two groups have no significant differenc at each time point during the follow up period(<i>P</i>>0.05).There was no significant difference between whole eye astigmatism and corneal astigmatism in A group and B gruop at 1 and 6mo after operation(<i>P</i>>0.05). Additionally, There was 1 case of IOL dislocation in each group after operation, which was further recovered by operation. Significant tilt and deviation of IOL were not observed in the rest of the patients during the follow up period. The other postoperative complications were mild with no difference in complications between the two groups(<i>P</i>>0.05).<p>CONCLUSION: For aphakic eyes without capsular support, both retropupillary iris claw IOL implantation and posterior chamber ciliary scleral suture fixed IOL are safe and effective surgical methods. Retropupillary iris claw IOL implantation has relatively simple operation, lower damage to the eyeball tissue, the shorter operation time, and the quicker recovery of postoperative visual acuity, which is one of the effective clinical treatments.

Translocation of the scleral suture knot on scleral-fixated posterior chamber intraocular lens

PURPOSE: To evaluate exposure rate of suture material at the transscleral suture fixation of posterior chamber intraocular lens (TSFPCIOL) with the method in which the scleral suture knots are trans positioned from both nasal and temporal sclera to superonasal. METHODS: With retrospective chart review 16 eyes of 15 patients who underwent TSFPCIOL with the transpositioned suture site, the authors checked their visual recovery rate and complicated disorders after the surgeries. RESULTS: Average corrected visual acuities at final visits improved to 0.67+/-0.32 from 0.14+/-0.17 at initial. Six eyes (37.5%) had complicated disorders at early postoperative period and 5 eyes (31.25%) had at their final visits. No exposure of suture material over the conjunctiva did occur. CONCLUSIONS: These results suggest that translocated suture to superotemporal sclera may be an efficient method for reducing exposure rate of suture material after TSFPCIOL.

Clinical Study of Transscleral Suture Fixation of Posterior Chamber Intraocular Lens after Pars Plana Vitrectomy

We reviewed medical records of 24 eyes which had undergone transscleral suture fixation of PC IOL after removal of clear or cataractous lens combined with pars plana vitrectomy from May 1992 to December 1996. The follow u[ [eropds fpr tjos seroes ramged frp, 54 to 772 days(mean 253 days). The visual acuity of 21 eyes (87.5%) was improved and that of 1 eyes(4.2%) was not changed. Postoperative complications, such as IOL precipitates(9 eyes), anterior chamber fibrin exudation (2 eyes), elevation of intraocular pressure(2 eyes)intraocular bleeding(2 eyes), corneal edema (1 eye), tilting of IOL(1 eye), decentration of IOL(1 eye), and retinal detachment(1 eye), were developed. Based on these results, transscleral suture fixation of PC IOL may be a good operative technique in aphakic eyes undergone pars plana vitrectomy and removal of lens.

Implantation of Posterior Chamber Intraocular Lens by Transscleral Suture Fixation: Long-term Results

The long-term results of implantation of posterior chamber intraocular lens (PC IOL) by transscleral suture fixation in 23 patients without zonular or capsular support were reviewed. Preoperatively, 15 were aphakic, 5 had cataracts and 3 were aphakic with concurrent corneal opactiy. The latter had penetrating keratoplasty as well at the time of surgery. They were followed up for more than 1 year, and the best corrected vision remained the same or improved in all cases after surgery. The transsclear sutre fixationrelated complications included vitreous hemorrhage, hyphema and retinal detachment.

Effect of Distances Between Corneoscleral Limbus and Transscleral Sutures on Vision and Refraction in Eyes with Posterior Chamber Intraocular Lens Implanted by Transscleral Suture Fixation

We retrospectively analyzed the correlation between location of transscIeral sutures and the postoperative vision, refraction, anterior chamber depth (ACD) with linear regression, in eyes with posterior chamber intraocular lenses (PCL's) implanted by transscleral suture fixation. The suture to limbus distances at 12 and 6 o'clock position measured in average 2.4mm and 1.7mm respectively. The location of the sutures had no statistically significant relationship with postoperative vision, spherical equivalent, astigmatism, ACD.

Implantation of Posterior Chamber Intraocular Lens by Transscleral Suture Fixation: Long-term Results

The long-term results of implantation of posterior chamber intraocular lens (PC IOL) by transscleral suture fixation in 23 patients without zonular or capsular support were reviewed. Preoperatively, 15 were aphakic, 5 had cataracts and 3 were aphakic with concurrent corneal opactiy. The latter had penetrating keratoplasty as well at the time of surgery. They were followed up for more than 1 year, and the best corrected vision remained the same or improved in all cases after surgery. The transsclear sutre fixationrelated complications included vitreous hemorrhage, hyphema and retinal detachment.

Effect of Distances Between Corneoscleral Limbus and Transscleral Sutures on Vision and Refraction in Eyes with Posterior Chamber Intraocular Lens Implanted by Transscleral Suture Fixation

We retrospectively analyzed the correlation between location of transscIeral sutures and the postoperative vision, refraction, anterior chamber depth (ACD) with linear regression, in eyes with posterior chamber intraocular lenses (PCL's) implanted by transscleral suture fixation. The suture to limbus distances at 12 and 6 o'clock position measured in average 2.4mm and 1.7mm respectively. The location of the sutures had no statistically significant relationship with postoperative vision, spherical equivalent, astigmatism, ACD.