AIM:To evaluate the clinical outcomes of a new minimally invasive technique using horizontal mattress sutures and Hoffman pockets for four-point refixation of dislocated fourhaptic intraocular lenses(IOLs).METHODS:Thi...AIM:To evaluate the clinical outcomes of a new minimally invasive technique using horizontal mattress sutures and Hoffman pockets for four-point refixation of dislocated fourhaptic intraocular lenses(IOLs).METHODS:This retrospective consecutive case series included eyes with dislocated Akreos AO60 IOLs underwent scleral refixation using a horizontal mattress doubleneedle suture technique with intralamellar knot burial via Hoffman pockets.Clinical outcomes assessed included pre-and postoperative best-corrected visual acuity(BCVA),intraocular pressure(IOP),spherical equivalent(SE),suture duration,IOL centration,and perioperative complications.RESULTS:A total of 10 eyes from 10 patients(6 males)were included.The mean age at the time of IOL refixation was 53.10±13.07y(range:28-68y).The mean interval between initial IOL implantation and dislocation was 8.44±3.54y.The mean postoperative follow-up duration was 11.45±10.30mo.Surgical time averaged 15.3±1.77min,with no intraoperative complications.The mean axial length was 27.16±4.35 mm,with high myopia(HM)as the leading comorbidity(4/10 eyes).Postoperative BCVA significantly improved compared to preoperative values(P=0.025).Postoperative SE was significantly improved compared with preoperative(P=0.01).All IOLs remained centered throughout follow-up.CONCLUSION:This minimally invasive four-point scleral fixation technique offers a safe and effective refixation strategy for dislocated four-haptic IOLs.The horizontal mattress suture configuration combined with Hoffman pockets facilitates durable centration,avoids conjunctival dissection,and could be adopted into routine surgical practice.展开更多
AIM:To describe a novel suture approach for transscleral fixation of C-loop intraocular lenses(IOL)and to compare the surgical outcomes with the four-haptics posterior chamber(PC)-IOL technique.METHODS:We retrospectiv...AIM:To describe a novel suture approach for transscleral fixation of C-loop intraocular lenses(IOL)and to compare the surgical outcomes with the four-haptics posterior chamber(PC)-IOL technique.METHODS:We retrospectively analyzed 16 eyes of 16 patients who underwent transscleral fixation of C-loop PCIOLs using a flapless one-knot suture technique,which were followed up for longer than 17mo.In this technique,the capsulorless IOL was suspended using a single suture for transscleral fixation of four feet.Then we compared its surgical outcomes and complications with the four-haptics PC-IOLs using the Student's t test and Chi-square test.RESULTS:Sixteen patients of 16 eyes with a mean age of 58.3±10.1y(42-76y)who received transscleral C-loop IOL implantation due to trauma,vitrectomy,or cataract surgery with inadequate capsule support showed improved visual acuity.The difference was not significant between two IOLs except the surgery time(P>0.05).The mean operation times of C-loop IOL surgery was 24.1±1.83min and 31.3±4.47min of the four-haptics PC-IOL method(P<0.0001).In the C-loop IOLs group,there was statistical difference between the preoperative and the postoperative UCVA(log MAR,1.20±0.50 vs 0.57±0.32,P=0.0003).There was no statistical difference between the preoperative and the postoperative BCVA(log MAR,0.66±0.46 vs 0.40±0.23,P=0.056).However,there was no statistically significant difference in postoperative UCVA and BCVA between the two IOLs(P>0.05).We did not detect any optic capture,IOL decentration or dislocation,suture exposed,or cystoid macular edema in patients underwent C-loop IOLs surgery.CONCLUSION:The novel flapless one-knot suture technique for transscleral fixation of C-loop IOL is a simple,reliable,and stable technique.展开更多
文摘AIM:To evaluate the clinical outcomes of a new minimally invasive technique using horizontal mattress sutures and Hoffman pockets for four-point refixation of dislocated fourhaptic intraocular lenses(IOLs).METHODS:This retrospective consecutive case series included eyes with dislocated Akreos AO60 IOLs underwent scleral refixation using a horizontal mattress doubleneedle suture technique with intralamellar knot burial via Hoffman pockets.Clinical outcomes assessed included pre-and postoperative best-corrected visual acuity(BCVA),intraocular pressure(IOP),spherical equivalent(SE),suture duration,IOL centration,and perioperative complications.RESULTS:A total of 10 eyes from 10 patients(6 males)were included.The mean age at the time of IOL refixation was 53.10±13.07y(range:28-68y).The mean interval between initial IOL implantation and dislocation was 8.44±3.54y.The mean postoperative follow-up duration was 11.45±10.30mo.Surgical time averaged 15.3±1.77min,with no intraoperative complications.The mean axial length was 27.16±4.35 mm,with high myopia(HM)as the leading comorbidity(4/10 eyes).Postoperative BCVA significantly improved compared to preoperative values(P=0.025).Postoperative SE was significantly improved compared with preoperative(P=0.01).All IOLs remained centered throughout follow-up.CONCLUSION:This minimally invasive four-point scleral fixation technique offers a safe and effective refixation strategy for dislocated four-haptic IOLs.The horizontal mattress suture configuration combined with Hoffman pockets facilitates durable centration,avoids conjunctival dissection,and could be adopted into routine surgical practice.
基金Supported by the Gongli Hospital of Pudong New Area,Shanghai(No.2017YQNJJ-13)。
文摘AIM:To describe a novel suture approach for transscleral fixation of C-loop intraocular lenses(IOL)and to compare the surgical outcomes with the four-haptics posterior chamber(PC)-IOL technique.METHODS:We retrospectively analyzed 16 eyes of 16 patients who underwent transscleral fixation of C-loop PCIOLs using a flapless one-knot suture technique,which were followed up for longer than 17mo.In this technique,the capsulorless IOL was suspended using a single suture for transscleral fixation of four feet.Then we compared its surgical outcomes and complications with the four-haptics PC-IOLs using the Student's t test and Chi-square test.RESULTS:Sixteen patients of 16 eyes with a mean age of 58.3±10.1y(42-76y)who received transscleral C-loop IOL implantation due to trauma,vitrectomy,or cataract surgery with inadequate capsule support showed improved visual acuity.The difference was not significant between two IOLs except the surgery time(P>0.05).The mean operation times of C-loop IOL surgery was 24.1±1.83min and 31.3±4.47min of the four-haptics PC-IOL method(P<0.0001).In the C-loop IOLs group,there was statistical difference between the preoperative and the postoperative UCVA(log MAR,1.20±0.50 vs 0.57±0.32,P=0.0003).There was no statistical difference between the preoperative and the postoperative BCVA(log MAR,0.66±0.46 vs 0.40±0.23,P=0.056).However,there was no statistically significant difference in postoperative UCVA and BCVA between the two IOLs(P>0.05).We did not detect any optic capture,IOL decentration or dislocation,suture exposed,or cystoid macular edema in patients underwent C-loop IOLs surgery.CONCLUSION:The novel flapless one-knot suture technique for transscleral fixation of C-loop IOL is a simple,reliable,and stable technique.