无晶体后囊的儿童外伤性白内障三襻人工晶体缝线固定术

目的探讨儿童外伤性白内障无晶体后囊眼的人工晶体植入术。方法对21例儿童外伤性白内障摘除后植入三襻后房型人工晶体，进行经巩膜缝线固定术。结果术后入工晶体位置全部正常，无偏斜，随访2～20个月，无并发症，视力增进。结论三襻后房型人工晶体缝线固定术，具有术后晶体不易倾斜和偏位的优点，是治疗无晶体后囊眼的有效方法。     

儿童Ⅱ期后房型人工晶体植入术的临床研究

目的　探讨儿童Ⅱ期后房型人工晶体植入术的方法及效果。方法　对 2 4例 ( 2 8眼 )伴有不同程度眼前段结构紊乱的儿童无晶状体眼患者 ,行Ⅱ期后房型人工晶体植入 ,包括联合行虹膜粘连松解、瞳孔成形、瞳孔区机化膜切除、前段玻璃体切除、人工晶体缝线固定等手术。结果　术后随访2～ 2 8个月。矫正视力≥ 0 3者 2 1眼 ,占 74 3 % ;人工晶体正位 2 3眼 ,占 82 2 %。术后炎性反应明显。无严重并发症。结论　Ⅱ期后房型人工晶体植入术是治疗儿童无晶状体眼的有效方法 ,选择手术适应证和掌握娴熟的操作技巧是手术成功的关键。     

无晶体后囊膜支持的后房型人工晶体植入术（二）

无晶体后囊膜支持的后房型人工晶体植入术（二）北京三○四医院眼科周朝辉综述四、并发症无后囊膜支持的后房型人工晶体的植入术的并发症包括全部人工晶体植入术的并发症，仅除外后囊膜混浊及后发性白内障，缝线固定并不能改变大多数并发症，这里仅讨论不同点．（一）缝线...     

后房型人工晶体缝襻术的技术探讨

目的 探讨对白内障囊内摘除术后的无晶体眼，计划性囊外摘除人工晶体中出现后囊大部分缺失以及后房型人工晶体脱体的眼，采用了后房型人工晶体缝襻固定术。方法 １９９３年１０月～１９９６年１２间连续对６４例病人做了后房型人工晶体缝襻术，从一根缝线两点固定，逐步发展到两根缝线四点固定，使得缝线技术逐渐简化。结果 术后晶体位置准确可靠，并发症不断减少。结论 后房型人工晶体缝襻术是人工晶体植入的有效方法。     

穿透性角膜移植联合经巩膜缝线固定的后房型人工晶体植入术

作者等于1987年10月至1991年9月对223例人工晶体植入眼及无晶体眼发生大泡性角膜病变者施行了穿透性角膜移植联合二期人工晶体植入手术或更换人工晶体。全部患者的晶体后囊膜已破裂并无足够的支撑力支撑后房型人工晶体。其中109例施行了开袢式(open-loop)前房型人工晶体植入,114例施行了经巩膜缝线固定的后房型人工晶体植入术。据一些学者报道,穿透性角膜移植术联合开袢式前房型人工晶体植入术已取得了肯定的效果,但尚存在一定的缺点,如对前房角的损伤,引起青光眼及进行性角膜内皮细胞减少等。而经巩膜缝线固定法植入后房型人工晶体亦取得了满意的效果,且比经虹膜缝线固定法有其优点如下;(1)虹膜缝线固定法植入后房型人工晶体手术后,瞳孔散大受影响,而经巩膜     

无晶体后囊的后房型人工晶体缝线固定术

报告３０例３０眼无晶体后囊的后房型人工晶体缝线固定术随访６～２２个月的结果。矫正视力≥０．６者占８０％，人工晶体无明显的偏心与倾斜。分别论述了选择性二期植入人工晶体，计划囊外摘除术中后囊破损一期植入人工晶体和人工晶体脱位于玻璃体腔的再固定之适应征、手术方法及作者的体会。结果表明，无晶体后囊的后房型人工晶体缝线可获得良好的效果。     

儿童玻璃体切除术后无晶状体眼的二期人工晶体植入术

目的评价儿童玻璃体切除术后无晶状体眼二期人工晶体植入术的视力效果、手术技巧及其安全性.方法对32例儿童眼内炎玻璃体切除术后的无晶状体眼行人工晶状体植入术.采用颞下方平坦部巩膜灌注,行后房型人工晶体睫状沟缝线固定术,术后随访6～24月.结果所有患者均达到或超过术前最佳矫正视力,术后裸眼视力＜0.1者2眼,0.1～0.2者8眼,0.2～04者16眼,＞05者4眼.无严重远期并发症.结论儿童眼内炎玻璃体切除术后二期人工晶体睫状沟缝线固定术,手术效果可靠,术后并发症少,是矫正儿童无晶状体眼的理想手术方法.     

无晶状体后囊支撑及后囊破裂后房型人工晶状体植入术临床体会

我院自1994年1月至1997年3月实施无晶状体后囊支撑及后囊破裂后房型人工晶状体植入术刀例，效果满意，现报告如下：一般情况：本组男24例，女6例。年龄6岁至73岁。右眼14例，左眼16例。老年白内障17例，外伤性白内障12例，其中合并玻璃体异物4例。先天性白内障1例。湖植入后房型人工晶状体力例，11期植入后房型人工晶状体10例。缝线固定植入术明例，利用残存前后囊做依托睫状沟内植入人工晶状体12例。手术方法：（l）无晶状体后囊支撑后房型人工晶状体缝线固定植入术。二期植入术选择无晶状体后囊支撑要求植入后房型人工晶状体的病例，术前…     

儿童人工晶体二期植入术

目的确定后房型人工晶体二期植入术矫正儿童无晶体眼的视力预后及手术适应证。方法对３４只儿童术后无晶体眼，在分离虹膜与后囊膜的粘连，形成足够的人工晶体植入放置空间后，根据后囊膜的完整与否，采用不同的技术二期植入后房型人工晶体。结果术后随访６～２４个月，２９只眼（８５．２９％）术后矫正视力等于或高于术前最佳矫正视力，１６只眼（４７．０６％）未矫正视力≥０．５，２８只眼（８２．３５％）矫正视力≥０．５。结论对于尚存完整或部分后囊膜的儿童无晶体眼，后房型人工晶体二期植入术是安全、有效的矫正方法。     

人工晶体缝线固定术睫状沟组织的免疫组织化学研究

目的观察后房型人工晶体睫状沟缝线固定术是否造成兔眼睫状沟组织细胞异常增殖。方法用９６只新西兰白兔建立动物模型，行后房型人工晶体睫状沟缝线固定和单纯固定术。分别于术后１／２、１、２、３个月摘除眼球，用免疫组织化学方法观察两种术式及正常眼（对照组）睫状沟部位组织细胞的增殖细胞核抗原反应。结果两种术式均未导致睫状沟组织细胞的异常增殖反应。结论睫状沟缝线固定术不失为处理后房型人工晶体植入术中后囊破裂及二期植入的可行术式。     

Double-knot transscleral suture fixation technique for displaced intraocular lenses

PURPOSE: To describe a simplified new technique for repositioning and attaching a suture to the haptic of a displaced posterior chamber intraocular lens (IOL). METHODS: We describe a double-knot technique for repositioning and transscleral suture fixation of a subluxed posterior chamber IOL after penetrating keratoplasty. Two 10-0 Prolene transscleral sutures on straight needles are passed around the IOL haptic, tied extraocularly, and used to secure the repositioned haptic of the IOL. A second knot ties the transscleral suture in the scleral bed, stabilizing the haptic in the ciliary sulcus. RESULTS: In the case described, the IOL was stable and well positioned 2 months after surgery. CONCLUSION: The double-knot technique for intraocular repositioning and transscleral suture fixation of displaced posterior chamber IOLs reduces the extensive intraocular manipulation and scleral incisions required for IOL exchange and may reduce chronic irritation associated with iris fixation.     

小切口无灌注折叠式人工晶状体悬吊术手术

目的 介绍并评价小切口无灌注下巩膜缝线固定可折叠人工晶状体的手术体会.方法 选择因晶状体后囊破裂或晶状体脱位不能正常植入后房型人工晶状体的19例.利用推注器系统,通过巩膜小切口把一片式可折叠人工晶状体植入后房,缝线固定在巩膜壁上.结果 术后视力均提高,11眼大于0.6,平均散光为（1.00±0.25）D,术后并发症少.结论 小切口无灌注折叠式人工晶状体悬吊术方法具有切口小,术中及术后并发症少,术后散光小、视力较好等优点.     

Scleral fixation of dislocated posterior chamber intraocular lenses: Temporary haptic externalization through a clear corneal incision

PURPOSE: To report the results of managing dislocated posterior chamber intraocular lenses (PC IOLs) by externalizing the haptics through a clear corneal incision. SETTING: The Retina Center at Pali Momi, Aiea, Hawaii, USA. METHODS: This retrospective consecutive series comprised cases in which a dislocated PC IOL was managed with pars plana vitrectomy. With this method, the dislocated PC IOL is retrieved and stabilized in the anterior chamber. The haptic is externalized through a clear corneal incision for suture knot placement and then reinserted. A scleral fixation suture is placed 1.25 mm posterior to the limbus under a scleral flap. RESULTS: The study included 14 eyes of 14 patients with a minimum follow-up of 6 months (median 15.4 months). There were 2 subluxated PC IOLs, 11 posteriorly dislocated PC IOLs, and 1 in-the-bag IOL dislocation. Postoperative vision and/or visual symptoms were stable or improved in 86% of eyes. Two eyes had worse vision caused by conditions not related to surgery including chronic cystoid macular edema from latanoprost use and optic atrophy. All IOLs were well fixated and stable, although 1 eye with asymmetric haptics had a slightly tilted IOL. CONCLUSIONS: Dislocated PC IOL management by externalizing the haptic through a clear corneal incision stabilized the IOL in the anterior chamber, minimized intraocular operative manipulations, and allowed easier placement of the opposite haptic over residual capsule, if available. Stable fixation was achieved without dislocation or IOL-related complications recurring.     

Modified transscleral fixation technique for refixation of dislocated intraocular lenses

PURPOSE: To evaluate the results of transscleral fixation of dislocated posterior chamber intraocular lenses (PC IOLs) by externalizing the haptics through a clear corneal incision. SETTING: Department of Ophthalmology, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. METHODS: This retrospective interventional case series comprised 21 eyes (21 patients) in which a dislocated posterior chamber IOL was transsclerally refixated using a small superior clear corneal incision for externalization of the haptics. The suture was tied to the externalized haptic, after which the tied haptic was placed back in the anterior chamber and dialed to externalize the second haptic. After the second externalized haptic was tied, the IOL was reimplanted in the ciliary sulcus. The minimum follow-up was 6 months. RESULTS: The mean follow-up was 42.7 months +/- 21 (SD). The difference between the mean best corrected visual acuity before IOL dislocation (0.34 +/- 0.21 logMAR) and the mean after IOL refixation (0.38 +/- 0.19 logMAR) was not statistically significant (P = .16, t test). During follow-up, the PC IOL remained well centered in all eyes and no tilt or dislocation was observed. CONCLUSION: Scleral fixation of dislocated PC IOLs using temporary haptic externalization through a clear corneal incision minimized the need for complicated intraocular maneuvers, had a low incidence of complications, and provided an easy and effective way to reposition dislocated PC IOLs.     

Ab externo scleral suture loop fixation for posterior chamber intraocular lens decentration: clinical results

PURPOSE: To evaluate the efficacy and safety of an ab externo suture retrieval and scleral fixation technique in the treatment of subluxated posterior chamber intraocular lenses (PC IOLs). SETTING: Academic tertiary care centers. METHODS: Surgical databases from 2 surgeons were reviewed for consecutive cases from March 2000 to April 2004 in which the ab externo scleral suture fixation technique was used and a minimum follow-up of 3 months was completed. Patient charts were reviewed for 15 eyes that had decentered in-the-bag PC IOLs, 12 eyes with subluxated sulcus or bag-sulcus positioned PC IOLs, and 3 eyes with PC IOLs dislocated into the vitreous. RESULTS: The mean time from cataract extraction to PC IOL stabilization was 3.4 years (range 2 days to 10.9 years). Surgical repositioning was successfully performed in all patients. After a mean follow-up of 14.7 months, the mean best corrected visual acuity (BCVA) improved from 20/140 to 20/40 (P = .0001). All patients had stable or improved BCVA. All patients with a successfully completed procedure achieved an adequately centered PC IOL postoperatively. One patient (3.3%) developed a significant intraoperative vitreous hemorrhage requiring the procedure to be aborted, but reoperation 3 months later was successful. Postoperative complications included persistent elevated intraocular pressure in 2 eyes (6.7%) and chronic cystoid macular edema in 1 eye (3.3%) that resolved with medication. CONCLUSION: The ab externo suture loop retrieval and scleral fixation technique was effective in repositioning decentered, subluxated, or dislocated PC IOLs with excellent visual outcomes.     

A knotless, one-haptic fixation of posterior chamber intraocular lenses:one-year results

AIM: To assess the results of a modified technique for scleral fixation of a posterior chamber intraocular lens (IOL) in eyes which had deficient of posterior capsular support. METHODS: This retrospective study was comprised of ten patients with deficient posterior capsular support who underwent one-haptic fixation of posterior chamber IOLs, between February 2010 and October 2011. IOL as implanted with one haptic supported on the capsular remnant and the other haptic drawn into the sulcus by anchoring suture without a knot. All patients were evaluated for pre- and postoperative visual acuity, lens centration, intra-and postoperative complications. RESULTS: A knotless, one-haptic fixation of posterior chamber IOLs has successfully been performed on ten eyes. All cases had inadequate capsular support (i.e. a capsular tear ranged from 5 to 7 clock hours). The average age was 74.25±8.87y (SD). The average postoperative uncorrected visual acuity was 0.51 logMAR. Complications included hyphema in one eye, a mild inflammatory reaction in the anterior chamber in two eyes, and a transient rise in IOP in one eye. Neither IOL tilt nor dislocation was observed and there were no later complications. CONCLUSION: In the presence of insufficient capsular support, a knotless, one-haptic fixation of posterior chamber IOLs is a safe and viable option which reduces the operation time, and minimizes postoperative suture-related complications.     

Suture fixation of a posterior chamber intraocular lens in anticoagulated patients

PURPOSE: To describe a technique of suture fixating posterior chamber silicone intraocular lenses (PC IOLs) to the iris through a limbal incision and to evaluate its effectiveness in preventing intraocular hemorrhages. SETTING: Price Vision Group, Indianapolis, Indiana, USA. METHODS: This retrospective single-center study comprised 7 eyes (5 patients) that had suture fixation of a silicone PC IOL from a limbal approach to the midperipheral iris using 9-0 polypropylene (Prolene(R)) suture. All patients were taking warfarin sodium (Coumadin(R)) preoperatively and postoperatively. At each follow-up examination, visual acuity and intraocular pressure were measured, the stability of the PC IOL was assessed, and the anterior chamber and posterior segment were evaluated for blood. RESULTS: There was no incidence of intraocular hemorrhage during surgery in any eye. In 6 eyes, there was no blood in the anterior chamber or posterior segment at any postoperative examination. A nonlayering hyphema that resolved within 1 week without sequelae was noted in 1 patient 6 weeks postoperatively. The mean follow-up was 10.7 months (range 6 to 25 months). CONCLUSION: Suture fixating a PC IOL to the iris through a limbal approach was an effective means of placing an IOL in anticoagulated patients without capsule support.     

Complications arising from iris-fixated posterior chamber intraocular lenses

Iris fixation of posterior chamber intraocular lenses (IOLs) is a technique that has been recommended for patients in whom a posterior chamber IOL is indicated but there is insufficient capsular support. We present 4 cases of iris-fixated posterior chamber IOLs with complications related to the procedure. Three patients developed postoperative slippage of the IOL, and 1 patient presented with iris erosion of the haptic leading to recurrent hemorrhage. Three cases were repaired by resuturing the same IOL using iris fixation, and in the last case IOL exchange with transscleral fixation of a posterior chamber IOL was performed. Final follow-up revealed stable IOLs in all cases.     

白内障术中后囊膜破裂行后囊膜连续曲线形撕囊术

目的：讨论白内障囊外摘除、超声乳化摘除及针吸摘除术中后囊膜破裂时行后囊膜连续曲线形撕囊术（ｐｏｓｔｅｒｉｏｒ ｃｏｎｔｉｎｕｏｕｓ ｃｕｒｖｉｌｉｎｅａｒ ｃａｐｓｕｌｏｒｈｅｘｉｓ,ＰＣＣＣ）的方法和作用。方法：利用撕囊镊对１０例（１０眼）白内障摘除术中后囊膜破裂眼行ＰＣＣＣ,５例联合行前段玻璃体切除术。结果：１０例后囊膜破裂后行ＰＣＣＣ眼９例成功完成ＰＣＣＣ,１ 均植入后房人工晶体。术后观察１月～３年（平均１６月）,９例行ＰＣＣＣ眼视轴均清晰,未发生视网脱离及后发性白内障,无明显的人工晶体光学部偏中心或人工晶体异位。结论：ＰＣＣＣ可有效避免后囊膜破孔进一步无限放射状撕裂,保持周边后囊膜的完整性。使人工晶体稳固于囊袋内。     

人工晶状体植入术中玻璃体脱出的处理

目的观察人工晶状体植入木中发生玻璃体脱出的处理及其效果。方法37眼人工晶状体植入手术中发生玻璃体脱出,使用剪刀-棉签行开放式前段玻璃体切除术,Ⅰ期植入后房型人工晶状体。结果成功植入或缝线固定植入后房型人工晶状体36眼（97.3％）,术后矫正视力≥0.5青28眼占76％。结论术中玻璃体脱出者施行玻璃体切除术并Ⅰ或植入后房型人工晶状体,仍可获得良好效果。