Yuki Kisanuki, Yasuhiko Asano, Eiji Tomoyori, Hidetoshi Onda
{"title":"使用 90° 弧形镊子固定巩膜内晶状体的套管辅助眼外技术:一种改良的眼外镊子引导技术。","authors":"Yuki Kisanuki, Yasuhiko Asano, Eiji Tomoyori, Hidetoshi Onda","doi":"10.1007/s10384-024-01099-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the surgical outcomes of intrascleral intraocular lens (IOL) fixation using a modified extraocular forceps-guided technique.</p><p><strong>Study design: </strong>Retrospective case series.</p><p><strong>Methods: </strong>Overall, 81 eyes of 78 patients who underwent intrascleral IOL fixation using the modified extraocular forceps-guided technique were included. The procedure entailed creating 2 scleral half-layer T-shaped incisions perpendicular to the main incision and forming a scleral tunnel. A 25-gauge trocar was inserted at the lower end of the T-shaped incision to perform vitrectomy. A 27-gauge needle was inserted from the left-hand port, and the leading haptic was inserted into the needle lumen. After removal of the right-hand trocar, a 90°-curved intrascleral fixation forceps was inserted into the eye, exposing the tip at the main incision, thus allowing the tip of the extraocular trailing haptic to be gripped and both haptics to be pulled out. The left-hand trocar was removed, and the haptics were buried in the scleral tunnel. The surgical outcomes of this technique were retrospectively evaluated on the basis of the medical records.</p><p><strong>Results: </strong>The induction of haptics was successful in all cases. The preoperative best-corrected visual acuity improved from 0.35±0.68 to 0.12±0.36 logMAR postoperatively (P<0.01). The refractive error was -0.27±0.87 D; IOL decentration, 0.39±0.18 mm; IOL tilt, 5.97±2.65°; IOL astigmatism, 0.35±0.36 D; and corneal endothelial cell loss, 10.3±12.7%. There were no serious complications related to the surgical technique.</p><p><strong>Conclusion: </strong>The modified extraocular forceps-guided technique allows for safe and straightforward induction of the trailing haptics and enables the performance of intrascleral IOL fixation with minimal scleral incisions.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Trocar-assisted extraocular technique for intrascleral intraocular lens fixation using a 90°-curved forceps: a modified extraocular forceps-guided technique.\",\"authors\":\"Yuki Kisanuki, Yasuhiko Asano, Eiji Tomoyori, Hidetoshi Onda\",\"doi\":\"10.1007/s10384-024-01099-7\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To investigate the surgical outcomes of intrascleral intraocular lens (IOL) fixation using a modified extraocular forceps-guided technique.</p><p><strong>Study design: </strong>Retrospective case series.</p><p><strong>Methods: </strong>Overall, 81 eyes of 78 patients who underwent intrascleral IOL fixation using the modified extraocular forceps-guided technique were included. The procedure entailed creating 2 scleral half-layer T-shaped incisions perpendicular to the main incision and forming a scleral tunnel. A 25-gauge trocar was inserted at the lower end of the T-shaped incision to perform vitrectomy. A 27-gauge needle was inserted from the left-hand port, and the leading haptic was inserted into the needle lumen. After removal of the right-hand trocar, a 90°-curved intrascleral fixation forceps was inserted into the eye, exposing the tip at the main incision, thus allowing the tip of the extraocular trailing haptic to be gripped and both haptics to be pulled out. The left-hand trocar was removed, and the haptics were buried in the scleral tunnel. The surgical outcomes of this technique were retrospectively evaluated on the basis of the medical records.</p><p><strong>Results: </strong>The induction of haptics was successful in all cases. The preoperative best-corrected visual acuity improved from 0.35±0.68 to 0.12±0.36 logMAR postoperatively (P<0.01). The refractive error was -0.27±0.87 D; IOL decentration, 0.39±0.18 mm; IOL tilt, 5.97±2.65°; IOL astigmatism, 0.35±0.36 D; and corneal endothelial cell loss, 10.3±12.7%. There were no serious complications related to the surgical technique.</p><p><strong>Conclusion: </strong>The modified extraocular forceps-guided technique allows for safe and straightforward induction of the trailing haptics and enables the performance of intrascleral IOL fixation with minimal scleral incisions.</p>\",\"PeriodicalId\":14563,\"journal\":{\"name\":\"Japanese Journal of Ophthalmology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Japanese Journal of Ophthalmology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10384-024-01099-7\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/7/31 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Japanese Journal of Ophthalmology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10384-024-01099-7","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/31 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的:研究使用改良的眼外镊引导技术固定巩膜内人工晶体(IOL)的手术效果:研究设计:回顾性病例系列:研究设计:回顾性病例系列。方法:共纳入了 78 名患者中的 81 只眼睛,这些患者均接受了使用改良眼外钳引导技术进行的巩膜内人工晶体固定术。手术需要在巩膜上开两个与主切口垂直的半层 T 形切口,形成巩膜隧道。在 T 形切口的下端插入 25 号套管,进行玻璃体切除术。从左侧切口插入 27 号针头,并将前导触针插入针腔。移除右侧套管后,将 90° 弧形巩膜内固定钳插入眼球,露出主切口处的尖端,这样就可以抓住眼外拖曳触针的尖端,将两个触针拔出。取出左侧套管,将触针埋入巩膜隧道。根据病历对该技术的手术效果进行了回顾性评估:结果:所有病例都成功诱导了触针。结果:所有病例的触觉诱导都很成功,术前最佳矫正视力从 0.35±0.68 提高到术后的 0.12±0.36 logMAR(PC结论:改良的眼外肌钳引导法是一种有效的手术方法:改良的眼外镊引导技术可以安全、直接地诱导拖曳触点,并以最小的巩膜切口进行巩膜内人工晶体固定。
Trocar-assisted extraocular technique for intrascleral intraocular lens fixation using a 90°-curved forceps: a modified extraocular forceps-guided technique.
Purpose: To investigate the surgical outcomes of intrascleral intraocular lens (IOL) fixation using a modified extraocular forceps-guided technique.
Study design: Retrospective case series.
Methods: Overall, 81 eyes of 78 patients who underwent intrascleral IOL fixation using the modified extraocular forceps-guided technique were included. The procedure entailed creating 2 scleral half-layer T-shaped incisions perpendicular to the main incision and forming a scleral tunnel. A 25-gauge trocar was inserted at the lower end of the T-shaped incision to perform vitrectomy. A 27-gauge needle was inserted from the left-hand port, and the leading haptic was inserted into the needle lumen. After removal of the right-hand trocar, a 90°-curved intrascleral fixation forceps was inserted into the eye, exposing the tip at the main incision, thus allowing the tip of the extraocular trailing haptic to be gripped and both haptics to be pulled out. The left-hand trocar was removed, and the haptics were buried in the scleral tunnel. The surgical outcomes of this technique were retrospectively evaluated on the basis of the medical records.
Results: The induction of haptics was successful in all cases. The preoperative best-corrected visual acuity improved from 0.35±0.68 to 0.12±0.36 logMAR postoperatively (P<0.01). The refractive error was -0.27±0.87 D; IOL decentration, 0.39±0.18 mm; IOL tilt, 5.97±2.65°; IOL astigmatism, 0.35±0.36 D; and corneal endothelial cell loss, 10.3±12.7%. There were no serious complications related to the surgical technique.
Conclusion: The modified extraocular forceps-guided technique allows for safe and straightforward induction of the trailing haptics and enables the performance of intrascleral IOL fixation with minimal scleral incisions.
期刊介绍:
The Japanese Journal of Ophthalmology (JJO) was inaugurated in 1957 as a quarterly journal published in English by the Ophthalmology Department of the University of Tokyo, with the aim of disseminating the achievements of Japanese ophthalmologists worldwide. JJO remains the only Japanese ophthalmology journal published in English. In 1997, the Japanese Ophthalmological Society assumed the responsibility for publishing the Japanese Journal of Ophthalmology as its official English-language publication.
Currently the journal is published bimonthly and accepts papers from authors worldwide. JJO has become an international interdisciplinary forum for the publication of basic science and clinical research papers.