Clinical Effect Of Secondary Intraocular Lens Suspension In Aphakia

Objective:To analyze the refractive results and related complications of secondary intraocular lens suspension in the treatment of aphakia,and to summarize the clinical effect of secondary intraocular lens suspension.Methods:In this study,we retrospectively analyzed the clinical data of patients who underwent secondary intraocular lens suspension in the ophthalmology center of the second Hospital of Jilin University in recent 10 years.The age,sex,intraocular pressure,primary disease,preoperative uncorrected visual acuity（UCVA）,best corrected visual acuity（BCVA）,axial length（AL）,intraocular lens power and target diopter were collected.Record the optometry,intraocular pressure,intraocular lens position,followup time and observe the occurrence of related complications during postoperative follow-up.The distance between corneal endothelium and the center of intraocular lens was measured by ultrasound biomicroscopy（UBM）,which was recorded as postoperative anterior chamber depth（ACD）.Taking the postoperative spherical equivalent as the actual postoperative diopter.The average difference from the target diopter to postoperative diopter was defined as the refractive error.All the results were statistically analyzed.Results:A total of 34 cases（34 eyes）were included.The postoperative best corrected visual acuity（Log MAR BCVA）was improved from 0.40±0.22 to 0.22±0.26（P < 0.05）.The postoperative visual acuity was improved in 23 eyes（67.6%）compared with preoperative best corrected visual acuity,the same as before in 10 eyes（29.4%）and decreased in 1 eye（2.9%）.The best corrected visual acuity of 22 eyes（64.7%）was better than 0.3Log MAR.The mean intraocular pressure（IOP）was（19.15±5.21）mm Hg preoperatively and（20.18±3.69）mm Hg postoperatively,and there was no significant difference between the two groups（P > 0.05）.The overall postoperative refractive results showed myopic drift（0.40 ±1.07）D,in which 11 eyes of intraocular lens were accurately implanted into ciliary sulcus,and the average refractive error was myopic drift（1.18±0.64）D.Postoperative anterior chamber depth is a risk factor for refractive error and is correlated with it.Complications: Seven eyes with transient ocular hypertension,which improved after topical use of IOP lowering drugs or clinical observation;corneal edema in 2 eyes;intraocular lens capture in 1 eye;the IOL was mildly tilted in 5 eyes;deviation of IOL in 1 eye;suture exposure in 1 eye and intraocular lens dislocation in 2 eyes.Conclusion:1 、 Secondary intraocular lens suspension is a safe and effective method for correcting aphakia,which can significantly improve visual acuity.2、In intraocular lens suspension,when the intraocular lens is placed in the ciliary sulcus,myopic drift will occur after operation.It is suggested that the planned intraocular lens power should be reduced by 0.5-1.0D to reduce the postoperative refractive error.3、It is relatively difficult to implant intraocular lens into ciliary sulcus during secondary intraocular lens suspension,so it is necessary to evaluate the position of ciliary sulcus and needle insertion site more accurately.4、Long-term complications such as suture exposure and suture fracture may occur in intraocular lens suspension.Postoperative attention should be paid to avoid trauma and strenuous exercise,and regular follow-up to avoid intraocular lens dislocation.