인공수정체의 원 위치의 봉합사 공막고정
In situ Scleral Suture Fixation of an Injector-delivered Intraocular Lens
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목적: 안구 내에서 인공수정체를 조작하는 새로운 방식의 공막고정술인 원 위치 공막고정술과 그 결과에 대해 보고하고자 한다. 증례요약: 본 후향적 증례보고는 인공수정체의 원 위치 공막고정술을 시행받은 환자 3명의 3안을 대상으로 하였다. 본 방법에서는인젝터를 이용해 인공수정체를 삽입한 뒤 선행하는 지지부(haptic)는 Siepser 미끄러짐 매듭법(Siepser sliding knot suture)을 이용해지지부를 안구 밖으로 꺼내지 않은 상태에서 인공수정체에 회전 등의 조작 없이 봉합하였으며 후행 지지부는 안구 밖에서 봉합한후 공막고정하였다. 수술 후 모든 안구에서 낭포황반부종 등의 합병증은 확인되지 않았다. 결과: 본 수술법은 기존 고전적인 인공수정체 공막고정 방식에 비해 수술 과정을 최소화하면서도 삽입된 인공수정체의 안정성을 높일수 있을 것으로 생각된다. 특히, 인공수정체를 이미 삽입한 이후에 수정체낭의 불안정성이 확인되어 전형적인 외부 공막고정술을 시행하기 위한 사전 계획 및 처치가 불가능한 상황에서 매우 효과적이다.
Abstract
Purpose: We evaluated a novel surgical technique for managing the intraocular lens (IOL) through in situ scleral fixation and its outcomes. Case summary: This retrospective case series included three eyes of three patients treated with the in situ scleral fixation technique for IOL. Our method involves suturing the haptics of an already intraocularly injected IOL in situ using a Siepser sliding knot suture, while the other haptic is tied externally. Notably, no intraoperative or postoperative complications, such as cystoid macula edema, were observed. Conclusions: This novel technique is a user-friendly and effective approach to improve IOL-capsular bag stability, requiring minimal intraocular intervention or preoperative preparation compared to conventional IOL scleral fixation methods. Furthermore, it is particularly effective for addressing concerns related to IOL-capsular bag stability following IOL insertion, as it eliminates the possibility of performing the typical IOL scleral fixation due to the absence of preoperative preparation and evaluation.
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