有缝线巩膜固定与改良Yamane无缝线巩膜固定短期临床效果比较

Tae Hwan Kim, Y. Kwon
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Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), total astigmatism, IOL astigmatism, refractive error, corneal endothelial cell density, surgical time and complications were compared before surgery, 1 week, 1 month, and 3 months after surgery.Results: In the two groups, after 3 months of surgery, UCVA and BCVA improved compared to before surgery, but there was no significant difference between two groups. The absolute refractive error and total astigmatism for one week after surgery and IOL astigmatism for one week and one month after surgery were significantly lower in sutureless fixation group. 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摘要

目的:比较和研究10-0聚丙烯缝线人工晶状体(IOL)巩膜固定术和改良Yamane无缝线人工晶状体巩膜固定术治疗IOL或晶状体脱位和无晶状体状态患者的短期临床效果。方法:回顾性分析2012年8月至2022年5月43例巩膜缝线固定患者和40例巩膜无缝线固定患者的病历。比较术前、术后1周、1个月和3个月的未矫正视力(UCVA)、最佳矫正视力(BCVA)、总散光、IOL散光、屈光不正、角膜内皮细胞密度、手术时间和并发症。结果:两组术后3个月,UCVA和BCVA均较术前有所改善,但两组间无显著差异。无缝线固定组术后1周的绝对屈光不正和全散光以及术后1周和1个月的IOL散光均显著降低。两组术后角膜内皮细胞密度变化无显著差异,无缝线固定组的总手术时间和IOL固定时间明显缩短。结论:尽管改良的Yamane无缝线人工晶状体巩膜内固定术与传统的无缝线人工晶体巩膜内固定法相比,视力没有显著提高,但无缝线固定术在术后早期提供了更好的人工晶状体稳定性,且手术时间短。因此,对于IOL或晶状体脱位和无晶状体状态的患者,它可以作为传统缝合巩膜固定的有效替代方案。
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Comparison of Short-term Clinical Outcomes between Sutured Scleral Fixation and Modified Yamane Sutureless Scleral Fixation
Purpose: To compare and investigate the short-term clinical outcomes between 10-0 polypropylene sutured intraocular lens (IOL) scleral fixation and modified Yamane sutureless IOL scleral fixation in patients with IOL or crystalline les dislocation and aphakic state.Methods: From August 2012 to May 2022, medical records were retrospectively analyzed for 43 patients with sutured scleral fixation and 40 patients with sutureless scleral fixation. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), total astigmatism, IOL astigmatism, refractive error, corneal endothelial cell density, surgical time and complications were compared before surgery, 1 week, 1 month, and 3 months after surgery.Results: In the two groups, after 3 months of surgery, UCVA and BCVA improved compared to before surgery, but there was no significant difference between two groups. The absolute refractive error and total astigmatism for one week after surgery and IOL astigmatism for one week and one month after surgery were significantly lower in sutureless fixation group. There was no significant difference in postoperative corneal endothelial cell density changes between two groups, and total surgical time and IOL fixation time were measured significantly lower in sutureless fixation group.Conclusions: Although modified Yamane sutureless IOL scleral fixation did not show significant improvement in visual acuity compared with conventional sutured IOL scleral fixation, sutureless fixation provided better stability of IOL in the early stages after surgery and short in the surgical time. So it can be an effective alternative to conventional sutured scleral fixation in patients with IOL or crystalline lens dislocation and aphakic state.
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