intraocular lens suture fixation

Intraocular lens implantation after cataract extraction is recognized as the safest and most effective method of implantation. However, due to various reasons, the posterior capsule of lens can not support the intraocular lens. The implantation of intraocular lens is more complicated. Anterior chamber intraocular lens or posterior chamber intraocular lens suture fixation, etc., in recent years, posterior chamber intraocular lens suture fixation has been widely used. The choice of which method is influenced by the experience and technique of the surgeon, corneal endothelial function, iris function and pupil morphology. There are many surgical methods for intraocular lens suture fixation. At present, there is no satisfactory technique. Generally, a rigid intraocular lens is used, and a scleral flap of 1/2 thickness is used. Treatment of diseases: metabolic cataract cataract Indication Intraocular lens suture fixation is suitable for: 1. The monocular aphakic eye that has undergone intracapsular cataract extraction is not tolerant to the contact lens, while the contralateral eye has good visual acuity. In order to obtain binocular monocular, suture fixation is clinically significant. 2. It is planned to perform extracapsular cataract extraction or phacoemulsification. After the operation, the capsule is ruptured or even the vitreous is released. It has been unconditionally implanted in the posterior chamber or intraocular lens. 3. Partial traumatic cataract extraction or spontaneous absorption, but still retain better visual function. In this type of case, although there is no complete posterior capsule support, or accompanied by anterior segmental structural disorders, in most cases, the intraocular lens can be implanted by suture fixation to obtain useful vision. 4. Replace the intraocular lens. One case is that the anterior chamber intraocular lens needs to be replaced by the posterior chamber intraocular lens due to intolerance; the other is the postoperative high refractive error caused by the calculation error of the original posterior chamber intraocular lens. The latter may be considered for suture fixation if there is no reliable posterior capsule support. 5. Supplemental suture fixation. In posterior chamber intraocular lens implantation, the suspensory ligament or posterior capsule of the equatorial can sometimes be damaged, and the eccentricity, displacement and tilt of the intraocular lens appear after operation. When these conditions have significantly affected vision or caused symptoms such as dizziness, discomfort, etc., the position can be adjusted by surgery, and if necessary, the suture fixation method can be used to reset it. Surgical procedure 1. Direct suture fixation without scleral flap: This is the simplest method of intraocular lens suture fixation, which can be used as a supplementary fixation method when a fixed fixation is found during surgery. The double needle suture is passed through the lamellar laminar hole of the lens, and then the needle is passed through the ciliary sulcus from the inside to the outside, and the needle is taken out from the surface of the sclera. The two needles are separated by 1 to 2 mm, and then the lens is implanted by the side of the line. The intraocular lens is implanted into the posterior chamber, the two sutures are ligated, and the knot is transferred into the tissue for burial. 2. The method of fixing the scleral flap from the inside to the outside is the same as the above method. First, two triangular scleral flaps are made at a predetermined fixed position, and then a double long needle thread is passed through the ciliary sulcus from the inside to the outside, and the needle is taken out from the bottom of the scleral flap. Also make the preset stitches on the opposite side to form two thread sleeves. The intraocular lens is fastened in the form of a loop. The intraocular lens is then implanted while the line is being retracted, and the suture is ligated when the position of the intraocular lens is adjusted. Finally, the scleral flap was resected and sutured. 3. The long needle is from the inside. Use the incision to hook out the suture in the eye. The sutures were cut from the middle, and each end was ligated through the intraocular lens and the chin knee line. Then, the intraocular lens is implanted and fixed to the ciliary sulcus by the method of side-by-side implantation.

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