在各种原因(外伤、术中后囊膜破裂、晶状体脱位等)导致的无充足囊袋支撑的情况下,常规的人工晶状体(Intraocular lens, IOL)植入方案实施困难。房角支撑型IOL和虹膜夹持型IOL因其较多的并发症现已不作为常规选择,因此,IOL巩膜固定术成为目前无充足囊膜支撑时的主流术式。从有缝线的IOL巩膜悬吊到无缝线的IOL巩膜层间固定,再到新型巩膜固定IOL的研发,术者们致力于提高手术效果的同时简化手术操作和减少术后并发症的发生,IOL巩膜固定手术技术得以不断改进,本文就IOL巩膜固定术的进展进行综述。Conventional intraocular lens (IOL) implantation is challenging in cases where sufficient capsular support is compromised due to various factors, such as trauma, intraoperative capsular rupture or lens dislocation. Angle-supported anterior chamber IOL and iris-clamp IOL are not standard options due to their associated complications. As a result, scleral fixation of the IOL has become the predominant choice in scenarios without sufficient capsular support. The evolution from sutured scleral suspension techniques for IOL to sutureless interscleral fixation methods and the introduction of novel scleral fixation IOL designs reflects surgeons’ efforts to improve surgical outcomes, streamline procedures and minimize postoperative complications. As a result, surgical techniques for scleral fixation of IOL continue to evolve. This article provides an overview of recent developments in scleral fixation of IOL.
白内障是眼科致盲性最高的眼病之一。随着白内障手术从复明性手术步入屈光性手术时代,传统老视矫正型人工晶状体已无法满足当今患者对于术后视觉质量的高要求。以往临床植入的晶状体多为单焦点人工晶状体,初步解决了术后远距离视力问题。但这种晶状体对中、近距离视力恢复效果不明显,仍满足不了患者全程脱镜的需求。景深延长型人工晶状体(Extended Depth-of-Focus Intraocular Lens, EDOF IOL)是一种新兴的技术,用于提高视力范围,特别是在中距离(例如,电脑工作所需的距离)。EDOF人工晶状体的出现可以填补单焦点和多焦点人工晶状体之间的空缺,其基于产生具有扩展深度的单焦点的原理,提供清晰的近距离视力。该设计的特点是通过引入一个低度的光学像差,使视觉在各个焦距之间有更平滑的过渡。Cataract is one of the most blinding diseases in ophthalmology. With the transition of cataract surgery from blindness prevention to refractive surgery, traditional presbyopic intraocular lenses can no longer meet the high requirements of patients for postoperative visual quality. In the past, most of the lenses applied in clinic were single-focus intraocular lenses, which initially solved the problem of long-distance vision after surgery. However, the effect of this kind of lens on the restoration of medium and short-distance vision is not obvious, and it still can not meet the needs of patients for full lens removal. Extended Depth-of-Focus Intraocular Lens (EDOF IOL) is an emerging technology for improving the range of vision, especially at medium distances (e.g. distances required for computer work). The emergence of EDOF IOL can fill the gap between single-focus and multi-focus IOL, based on the principle of producing a single focal point with an extended depth to provide a clear distance to near vision. The design features a smoother transition of vision between focal lengths by introducing a low degree
