| Objective:The study was to investigate the clinical efficacy of a foldable posterior chamber intraocular lens in the suture fixation of pars plana,and to provide reference for future clinicians to choose the location of artificial lens suspension.Methods:This study used a retrospective case control study,we collected from March 2014 to July 2017 in Ophthalmic Center Qingdao municipal hospital underwent scleral suture fixation of intraocular lens in patients with 70 cases.These patients were divided into two groups according to the fixed position of the intraocular lens: In group A,37 cases(37 eyes)underwent pars plana intraocular lens(IOL)suture fixation;In group B,33 cases(33 eyes)underwent intraocular lens ciliary sulcus suture fixation.All the above operations were performed by the same physician in the ophthalmology center of the hospital.After surgery,we observed the corneal edema,aqueous humor cells and aqueous flicker in A and B two groups by slit lamp microscope.At the same time,the location of intraocular lens and related complications were observed by B type ultrasound and ultrasound biomicroscopy(UBM).Recorded in various cases of two groups of postoperative 1 week,1 month and 3 months refractive deviation,visual acuity,intraocular pressure and postoperative complications.The obtained data was statistically analyzed by using SPSS 22.0 software.Results :The results of this study are presented in the following four indicators.1.Refractive deviation: The absolute value of refractive deviation in A group of postoperative 1 week,1 month and 3 months was significantly smaller than that of B group,the difference was statistically significant(P< 0.05).2.Visual acuity(VA): VA increased significantly(P< 0.01)in both group between preoperation and postoperation.The visual acuity of postoperative 1 week was better than preoperation,the visual acuity of postoperative 1 month was better than preoperation and postoperative 1 week,the visual acuity of postoperative 3 months was the best,above of these differences were statistically significant(P< 0.05).There was no significant difference in the visual acuity between the postoperative 1week,1month and3 months in the group of A and B(P> 0.05).3.Intraocular Pressure(IOP):The first day after the operation,there was 1 case in group A and 2 cases in group B with the intraocular pressure exceeding 23 mmHg respectively.The second day after the operation,each of groups had one case with the intraocular pressure unexceeding 10 mmHg.During the follow-up observation,the corresponding treatment measures were taken according to the changes of intraocular pressure,and all of them recovered to the normal range.The intraocular pressure of two groups reached the peak at postoperative 1 week,which was higher than other time,the difference had statistically significant(P< 0.05).There was significant difference for the intraocular pressure between group A and group B on the postoperative 1 week and1month(P< 0.05).The intraocular pressure had no significant difference between the two groups on the 3 months after opertion(P> 0.05).4.Postoperative Complications: A group of 37 cases(37 eyes)after surgery occurred in 3 cases of surface contact closely intraocular lens loop and iris,2 cases of pigment dispersion syndrome,2 cases of reverse pupillary block,its occurrence rate was respectively 8.10%,5.41% and 5.41%;Group A didn't occurrence pigmentary glaucoma and hyphema.B group of 33 cases(33 eyes)after surgery occurred in 24 cases of surface contact closely intraocular lens loop and iris,24 cases of pigment dispersion syndrome,21 cases of reverse pupillary block,12 cases of pigmentary glaucoma,2cases of hyphema,its occurrence rate was respectively 72.73%,72.73%,63.64%,and36.36% 6.06%.In group B,the rate of surface contact closely intraocular lens loop and iris,pigment dispersion syndrome,reverse pupillary block,pigmentary glaucoma was higher than that of A group,the difference was statistically significant(P< 0.05).There were no intraocular lens tilt and displacement,suture line exposure,endophthalmitis,retinal detachment and cystoid macular edema after operation in two groups of A and B.Conclusion: Pars plana suture fixation of one-piece foldable posterior chamber intraocular lens is safe and feasible.Posterior chamber intraocular lens fixation after pars plana suture fixation has advantages of small refractive deviation,good vision recovery,stable intraocular pressure and less postoperative complications.The reservation degree of IOL can be obtained directly.The pars plana is more suitable than the ciliary sulcus to be selected as the location of fixed intraocular lens.However,its long-term efficacy and complications still need further observation. |
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