白内障手术后的眼内晶状体交换或更换。

IF 1.9 4区医学 Q2 OPHTHALMOLOGY International journal of ophthalmology Pub Date : 2024-11-18 eCollection Date: 2024-01-01 DOI:10.18240/ijo.2024.11.08

Arundhati Dvivedi, Somasheila I Murthy, Sukesh Manga

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引用次数: 0

摘要

目的：报告眼内人工晶体（IOL）置换/植入手术的发生率、适应症和视觉效果：对2017年1月1日至2022年12月31日期间需要进行人工晶体置换/植入手术的60只眼睛进行回顾性分析。方法：回顾性分析2017年1月1日至2022年12月31日期间需要进行人工晶体置换/植入手术的60只眼睛，分析总体结果以及实习医生与经验丰富的外科医生之间的比较：在为期六年（2017-2022 年）的 39 778 例白内障手术（无眼部并发症）中，有 60 例（0.15%）需要进行人工晶体置换/植入手术。其中 36/60 例（60%）由训练有素的外科医生实施，24/60 例（40%）由经验丰富的外科医生实施。最常见的适应症是人工晶体脱位（26 例，占 43.3%），其次是人工晶体脱位（20 例，占 33.3%），术后屈光意外（7 例，占 11.6%），人工晶体诱发葡萄膜炎（5 例）和触点断裂（2 例）。24眼（40%）在初级手术中出现术中并发症。最常见的二次人工晶体是后房型人工晶体（PCIOL），有 21 眼（35%），巩膜固定型人工晶体有 20 眼（31.6%），前房型人工晶体有 13 眼（21.6%），虹膜固定型人工晶体有 3 眼（5%），还有 3 眼（5%）无晶体眼。初次手术和二次手术的平均间隔时间为 168 天（168±338.8）。最佳矫正视力（BCVA）大于 20/60 的有 43 眼（71.66%），20/80-20/200 的有 14 眼（23.33%），20/250 的有 2 眼，手部运动的有 1 眼。术后一个月，受训者与经验丰富的外科医生的视力结果无明显统计学差异（UCVA 0.45±0.29 vs 0.53±0.32，P=0.20；BCVA 0.34±0.25 vs 0.37±0.26，P=0.69）：结论：人工晶体脱位是最常见的适应症，后囊破裂是最常见的术中风险因素。这种并发症可以通过选择合适的辅助人工晶体得到有效解决，70%以上的患者可获得良好的视觉效果。

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Intraocular lens exchange or explantation post cataract surgery.

Aim: To report incidence, indications, and visual outcomes of intraocular lens (IOL) exchange/explantation surgery.

Methods: Retrospective analysis of 60 eyes requiring IOL exchange/explantation surgery between 1^st January 2017 and 31^st December 2022. The overall outcomes as well as comparison between the trainee versus experienced surgeons were analyzed.

Results: Out of 39 778 cataract surgeries (with no preexisting ocular co-morbidities) during a six-year period (2017-2022), 60 (0.15%) needed IOL exchange/explantation. Surgeons-under-training performed 36/60 cases (60%) while 24/60 (40%) were by experienced surgeons. The commonest indication was subluxated IOL in 26 (43.3%), followed by dislocated IOL in 20 (33.3%), postoperative refractive surprise in 7 (11.6%), IOL induced uveitis in five and broken haptic in two eyes. Twenty-four (40%) eyes had intraoperative complications during primary surgery. Posterior chamber IOL (PCIOL) was the commonest secondary IOL in 21 (35%) eyes, scleral fixated in 20 (31.6%), anterior chamber IOL (ACIOL) in 13 (21.6%), iris fixated IOL in three (5%) and three eyes (5%) were left aphakic. The mean time between primary and secondary surgery was 168d (168±338.8). Best corrected visual acuity (BCVA) of >20/60 was obtained in 43 eyes (71.66%), 20/80-20/200 in 14 (23.33%), 20/250 in two and hand movements in one. No statistically significant difference in visual outcome was noted at post-op one month between trainees versus experienced surgeons (UCVA 0.45±0.29 vs 0.53±0.32, P=0.20, BCVA 0.34±0.25 vs 0.37±0.26, P=0.69).

Conclusion: IOL subluxation as the commonest indication and posterior capsular rupture is the commonest intraoperative risk factor. This complication can be effectively addressed with selection of the appropriate secondary IOL achieving good visual outcomes in over 70% of patients.

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来源期刊

International journal of ophthalmology Medicine-Ophthalmology

CiteScore

2.50

自引率

7.10%

发文量

3141

审稿时长

4-8 weeks

期刊介绍： · International Journal of Ophthalmology-IJO (English edition) is a global ophthalmological scientific publication and a peer-reviewed open access periodical (ISSN 2222-3959 print, ISSN 2227-4898 online). This journal is sponsored by Chinese Medical Association Xi’an Branch and obtains guidance and support from WHO and ICO (International Council of Ophthalmology). It has been indexed in SCIE, PubMed, PubMed-Central, Chemical Abstracts, Scopus, EMBASE , and DOAJ. IJO JCR IF in 2017 is 1.166. IJO was established in 2008, with editorial office in Xi’an, China. It is a monthly publication. General Scientific Advisors include Prof. Hugh Taylor (President of ICO); Prof.Bruce Spivey (Immediate Past President of ICO); Prof.Mark Tso (Ex-Vice President of ICO) and Prof.Daiming Fan (Academician and Vice President, Chinese Academy of Engineering. International Scientific Advisors include Prof. Serge Resnikoff (WHO Senior Speciatist for Prevention of blindness), Prof. Chi-Chao Chan (National Eye Institute, USA) and Prof. Richard L Abbott (Ex-President of AAO/PAAO) et al. Honorary Editors-in-Chief: Prof. Li-Xin Xie(Academician of Chinese Academy of Engineering/Honorary President of Chinese Ophthalmological Society); Prof. Dennis Lam (President of APAO) and Prof. Xiao-Xin Li (Ex-President of Chinese Ophthalmological Society). Chief Editor: Prof. Xiu-Wen Hu (President of IJO Press). Editors-in-Chief: Prof. Yan-Nian Hui (Ex-Director, Eye Institute of Chinese PLA) and Prof. George Chiou (Founding chief editor of Journal of Ocular Pharmacology & Therapeutics). Associate Editors-in-Chief include: Prof. Ning-Li Wang (President Elect of APAO); Prof. Ke Yao (President of Chinese Ophthalmological Society) ; Prof.William Smiddy (Bascom Palmer Eye instituteUSA) ; Prof.Joel Schuman (President of Association of University Professors of Ophthalmology,USA); Prof.Yizhi Liu (Vice President of Chinese Ophtlalmology Society); Prof.Yu-Sheng Wang (Director of Eye Institute of Chinese PLA); Prof.Ling-Yun Cheng (Director of Ocular Pharmacology, Shiley Eye Center, USA). IJO accepts contributions in English from all over the world. It includes mainly original articles and review articles, both basic and clinical papers. Instruction is Welcome Contribution is Welcome Citation is Welcome Cooperation organization International Council of Ophthalmology(ICO), PubMed, PMC, American Academy of Ophthalmology, Asia-Pacific, Thomson Reuters, The Charlesworth Group, Crossref,Scopus,Publons, DOAJ etc.