The Stability Of Transscleral Suture-fixated Posterior Chamber Intraocular Lens Implantation: Comparison Of Double Sutured Fixation And Single Sutured Fixation

Purpose:To observe the stability and curative effect of the posterior chamber intraocular lens(IOL)fixed by aphakic suture through the scleral suture,and compare the advantages and disadvantages of double sutured scleral fixated and single sutured scleral fixated.Method:A retrospective case-control study was conducted to collect 25 patients with aphakic and scleral suture fixation from the Department of Ophthalmology,the First Affiliated Hospital of Nanchang University from November 2016 to December 2018.Eyes were divided into two groups according to the operation: DSF-IOL group(double sutured scleral fixated IOL)13 persons of 14 eyes;SSF-IOL group(single sutured scleral fixated IOL)12 persons of 12 eyes.Main outcome measures: Intraocular pressure,uncorrected visual acuity,best corrected visual acuity,corneal endothelial cell count,IOL level and vertical tilt distance and offset,tilt distance of IOL surgical site,preoperative and postoperative 3 months The IOL eccentric distance and the position of the ankle,where the IOL position is observed and measured by a slit lamp and an ultrasound biomicroscope.Statistical analysis was performed by IBM-SPSS 20.0 and Graphpad prism 8.Continuous samples(age,visual acuity,IOL tilt and eccentricity,etc.)were subjected to independent sample t-test and datas were recorded as mean ± standard deviation(`x ± SD);Fisher's exact test was used for counting datas.Result:1.The visual acuity of the naked eye in the DSF-IOL group and the SSF-IOL group was significantly higher than that before the operation(P<0.01).There was no significant difference between the two groups in the best corrected visual acuity(P>0.05).2.The offset distance and offset of the DSF-IOL group in the vertical direction were smaller than those in the SSF-IOL group(P<0.05).There was no significant difference in the horizontal tilt distance and offset between the two groups(P>0.05).There was no significant difference in the eccentric distance between the two groups and the tilt distance of the surgical site(P>0.05).3.There was no significant difference in intraocular pressure and anterior chamber depth between the two groups(P>0.05).There was no significant difference in the number of corneal endothelial cell loss between the two groups(P>0.05).4.There were 28 sputum in the DSF-IOL group: 15 cases(53.6%)in the ciliary sulcus,12 cases(42.8%)in the ciliary crown,and 1 case(3.6%)in the ciliary crown;24 in the SSF group: There were 12 cases(50.0%)of ciliary sulcus,10 cases(41.7%)of ciliary sulcus,and 2 cases(8.3%)of ciliary crown.There were 3 cases(21.4%)and 3 cases(25%)in the two groups.Conclusion:1.After the vitrectomy,the second posterior chamber IOL implantation,both surgical methods have achieved good visual;2.The single sutured scleral fixation group has a smaller degree of deviation in the vertical direction than double sutured scleral fixated group intraocular lens,which can be used as the first choice;3.UBM can be used as an effective test to assess the stability of postoperative IOL.