Visual Outcomes, Endothelial Loss, and Complications Following Iris-Claw Intraocular Lens Implantation and Trocar-Assisted Sutureless Scleral Fixation of Intraocular Lenses

Ebubekir Durmus, V. Aykut, M. Hepokur, Fatma Sali, H. Sanisoglu, Halit Oguz, F. Esen
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Abstract

Objectives: Iris-claw intraocular lens (IC-IOL) implantation and sutureless scleral fixation of intraocular lenses (SSF-IOL) are two commonly preferred surgical approaches for the management of aphakic patients without sufficient capsular support. The aim of this study was to compare the outcomes of IC-IOL implantation and trocar-assisted SSF-IOL implantation. Methods: The medical records of secondary IOL implantation patients were retrospectively reviewed. All patients had a detailed ophthalmological examination, including LogMAR best-corrected distance visual acuity (CDVA), intraocular pressure (IOP), and endothelial cell density (ECD) preoperatively and postoperatively. SPSS 21.0 software was used for the statistical analysis. Results: There were 15 patients in the IC-IOL group and 12 patients in the SSF-IOL group. Age and gender distributions were similar between the groups (p=0.456 and p=0.398, respectively). Similarly, patients in both groups had similar CDVA preoperatively and postoperatively (p=0.51, p=0.48, respectively). Both IC-IOL and SSF-IOL implantation significantly increased CDVA (p=0.001 and p=0.005, respectively). IOP remained unchanged in both groups. However, ECD reduced significantly following both IC-IOL and SSF-IOL implantation (p=0.001 and p=0.005, respectively) and trocar-assisted SSF-IOL implantation resulted in significantly more endothelial loss compared to IC-IOL implantation (439.5±89 vs. 164.4±53, p=0.013). Conclusion: Both surgical approaches increased CDVA significantly and at similar levels. However, trocar-assisted SSF-IOL implantation resulted in significantly more endothelial loss compared to IC-IOL implantation. None of the patients developed bullous keratopathy, but this difference should be kept in mind, especially in patients with critically low ECD.
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虹膜爪式眼内透镜植入术和套管辅助无缝线巩膜固定眼内透镜术后的视觉效果、内皮损失和并发症
目的:虹膜-爪式人工晶状体植入术和无缝合线巩膜固定人工晶状体是治疗无晶状体包膜支持的无晶状体患者的两种常用手术方法。本研究的目的是比较IC-IOL植入术和套管针辅助SSF-IOL植入术的结果。方法:回顾性分析二期人工晶状体植入术患者的临床资料。所有患者术前和术后均进行详细的眼科检查,包括LogMAR最佳矫正距离视力(CDVA)、眼压(IOP)和内皮细胞密度(ECD)。采用SPSS 21.0软件进行统计分析。结果:IC-IOL组15例,SSF-IOL组12例。组间年龄和性别分布相似(p=0.456、p=0.398)。同样,两组患者术前和术后CDVA相似(p=0.51, p=0.48)。IC-IOL和SSF-IOL均显著提高CDVA (p=0.001和p=0.005)。两组的IOP保持不变。然而,IC-IOL和SSF-IOL植入术后ECD均显著降低(p=0.001和p=0.005),套管针辅助SSF-IOL植入术后内皮细胞损失明显高于IC-IOL(439.5±89比164.4±53,p=0.013)。结论:两种手术入路均可显著提高CDVA,且水平相近。然而,套管针辅助的SSF-IOL植入术与IC-IOL植入术相比,内皮细胞损失明显更多。没有患者发生大疱性角膜病变,但应记住这种差异,特别是在ECD极低的患者中。
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