眼内窥镜协助行人工晶状体睫状沟缝线固定术

目的:对比研究在眼内窥镜协助下行人工晶状体睫状沟缝线固定术与传统手术方法的手术效果及并发症。方法:选取30例要求进行人工晶状体植入而没有足够囊膜支撑的患者,随机分成A,B两组,每组各15例。A组按照传统方法进行人工晶状体睫状沟缝线固定术,B组在眼内窥镜的监视下进行人工晶状体睫状沟缝线固定术,对其手术并发症及术后效果进行定期观察和分析。结果:所有患者均顺利完成手术,1mo随访时的术后裸眼视力:A组为0.1～0.6,B组为0.15～0.8,两组患者术后裸眼视力均较术前裸眼视力有不同程度提高,两组间裸眼视力相比差异有统计学意义(t=2.351,P<0.05)。1mo随访时的术后最佳矫正视力:A组为0.3～0.6,B组为0.3～0.8,两组间患者的最佳矫正视力相比差异没有统计学意义(t=1.327,P>0.05)。A组出现较多并发症:3例角膜水肿、3例葡萄膜炎、4例前房积血、2例玻璃体积血、3例人工晶状体偏位或倾斜、1例虹膜周边前粘连、2例眼压升高。B组仅出现少量轻微并发症,包括5例角膜水肿、2例葡萄膜炎。结论:在眼内窥镜的协助下进行人工晶状体睫状沟缝线固定术可以确保手术缝线固定的位置位于睫状沟,与传统方法相比手术并发症明显减少,手术效果较好。     

Original three-point fixation technique for sutured posterior chamber intraocular lens

PURPOSE AND METHODS: In order to avoid the complications associated with posterior chamber intraocular lens (IOL) scleral fixation, the authors have developed an original surgical technique by which the IOL is secured at the ciliary sulcus by suturing the haptics to the sclera in three points (at the 3, 5 and 9 o'clock positions). This technique was utilized for secondary IOL implantation in 21 aphakic eyes. The mean follow-up was 18 months, range 6-28 months. RESULTS: All eyes that underwent secondary implants had equal or better visual acuity postoperatively; none developed serious intra- or postoperative complications. No tilt or decentration of the IOL was observed postoperatively. DISCUSSION: The technique described appeared easy to perform and produced good visual outcomes with stable transscleral fixation of the IOL.     

改良后房型人工晶状体缝线固定术临床观察

目的：评价改良的后房型人工晶状体经巩膜缝线固定术的临床疗效。方法：将82例拟行后房型人工晶状体经巩膜缝线固定术的患者随机分成两组：改良后的无巩膜瓣线结埋藏式及经睫状体平坦部固定组;常规的有巩膜瓣经睫状沟缝线固定组。分别观察两组的手术时间、术后视力、术后并发症。结果：本研究中改良组的手术时间平均为39.95±5.87min,常规巩膜瓣组的时间平均为45.77±5.21min,两组手术时间存在显著差异。术后视力两组无显著差异。两组均未发生线结外露缝线磨损、术后眼内炎、视网膜脱离并发症。常规巩膜瓣组易出现人工晶状体光学部夹持现象。结论：改良的后房型人工晶状体经巩膜缝线固定术是一种矫正无足够后囊膜支持眼的安全、有效、简洁的术式。     

改良折叠式人工晶状体悬吊术治疗外伤性晶状体脱位

目的：评价改良折叠式人工晶状体(IOL)悬吊治疗外伤性晶状体脱位的手术技术。

方法：前瞻性随机对照研究。共15例患者接受了改良折叠式IOL悬吊手术。其中,9例患者选择了Akreos AO IOL,使用聚丙烯缝线穿过IOL的环状襻,经巩膜引导穿刺后,缝合线末端热膨胀固定在巩膜。6例患者选择了Tecnis ZA9003 IOL,未使用缝合线,巩膜穿刺引导IOL襻穿出巩膜后,直接将IOL襻末端热膨胀固定在巩膜内。观察所有患者的最佳矫正视力(BCVA,LogMAR)及术后并发症。

结果：研究共纳入15例患者,其中男7例,女8例,平均年龄64.00±9.85岁,平均病程5.80±3.17wk。人口统计学和基线临床特征之间没有显著差异。接受改良折叠式IOL悬吊手术后,所有患者视力均有明显改善。术后3mo,患者的BCVA(LogMAR)从1.28±0.56改善至0.52±0.30。其中,选择Akreos AO IOL患者的BCVA(LogMAR)从1.39±0.62改善至0.59±0.25,选择Tecnis ZA9003 IOL患者的BCVA(LogMAR)从1.12±0.45改善至0.42±0.35。此外,在我们的研究中没有观察到严重的术后并发症。仅1例患者IOL脱位,IOL光学面轻度倾斜。

结论：改良折叠式IOL悬吊手术具有良好的视觉效果和预后,无严重并发症,是IOL悬吊手术的有效选择。     

A review of suturing techniques for posterior chamber lenses

PURPOSE OF REVIEW: To evaluate the outcome of last the 15 years' experience with the transscleral suture fixation technique of posterior chamber intraocular lens (PC IOL). RECENT FINDINGS: The implant of an anterior chamber IOL, especially the iris-claw lens, is safer and a better option than the transsclerally fixed IOL. SUMMARY: After bibliographic review of anterior chamber lenses implant results with transscleral fixation, we conclude that the number of complications is less in the iris fixation lens.     

Efficacy of scleral-fixated 3-looped haptics intraocular lens implantation for surgical management of microspherophakia

AIM: To evaluate the safety and efficacy of scleral-fixated 3-looped haptics intraocular lens (IOL) implantation for surgical management of microspherophakia. METHODS: A retrospective case series include 10 microspherophakic patients (15 eyes) who underwent lens removal plus a modified surgical treatment of scleral-fixated 3-looped haptics IOL implantation. The primary outcomes involved visual acuity, intraocular pressure (IOP). Secondary outcomes were spherical equivalent (SE), anterior chamber depth (ACD), corneal endothelial cell density and postoperative complications. RESULTS: After a postoperative follow-up of 17.60±15.44mo, improved visual outcomes can be observed. The uncorrected distance visual acuity (UCVA) logMAR improved from 1.54±0.59 preoperatively to 0.51±0.35 postoperatively (P=0.001), and best corrected visual acuity (BCVA) logMAR improved from 0.97±0.91 preoperatively to 0.24±0.23 postoperatively (P=0.003). Moreover, the SE decreased from -9.58±7.47D preoperatively to -0.65±2.21 D postoperatively (P<0.001). In terms of safety profile, the average IOP decreased from 21.10±12.94 mm Hg preoperatively to 14.03±3.57 mm Hg postoperatively (P=0.044), and the previously elevated IOP of three eyes decreased to the normal range. The ACD increased from 2.25±1.45 mm preoperatively to 3.35±0.39 mm postoperatively (P=0.017). The density of corneal endothelial cells did not change significantly after surgery (P=0.140). The posterior chamber IOLs were well centered and no severe complications were found. CONCLUSION: Lens removal plus the modified surgical treatment of scleral-fixated 3-looped haptics IOL implantation can help in improvement of visual acuity, which can be regarded as a relative safe method for the surgical management of microspherophakia.     

Efficacy of haptic sutured in-the-bag intraocular lens for intraocular lens-capsule complex stability: a comparison of three insertion methods

AIM: To evaluate the efficacy and stability of haptic sutured in-the-bag intraocular lens (IOL) in eyes with zonular instability. METHODS: A total 60 eyes of 60 patients were included in this retrospective cohort study. Postoperative stability in three groups [haptic sutured IOL in the bag, IOL in the bag insertion with haptics oriented toward areas of zonulysis, IOL with capsular tension ring (CTR) in the bag insertion] were compared according to the IOL insertion methods. To evaluate the IOL stability, the changes of anterior chamber depth (ACD), refraction, contraction of anterior continuous curvilinear capsulotomy (CCC) area, and tilt of IOL were compared. RESULTS: There was no significant difference in change of ACD (-0.04±0.01 mm in group of haptic sutured IOL, -0.07±0.01 mm in group of CTR insertion) and refraction (0.05±0.05 D in group of haptic sutured IOL, 0.37±015 D in group of CTR insertion) between the group of haptic sutured IOL in the bag and CTR insertion group. But in comparison of CCC contraction and IOL tilt, CTR insertion group showed less contraction (1.00%±0.52%) and less IOL tilt (2.66°±0.11°) than the group of haptic sutured IOL in the bag (6.32%±1.36%, 3.47°±0.11°, respectively). The CTR insertion group showed the least CCC contraction and the least tilt. CONCLUSION: In eyes with zonular instability, the method of haptic sutured IOL in-the-bag shows comparable stability in ACD and refraction in comparison with IOL with CTR in the bag insertion. The method of IOL only in-the-bag insertion shows the largest contraction of CCC and the largest tilt of IOL.     

Endoscope-assisted transscleral suture fixation to reduce the incidence of intraocular lens dislocation

PURPOSE: To examine the surgical complications of transscleral sulcus suture of posterior chamber intraocular lenses (IOLs) and to compare the rates of surgical complications between patients in the nonendoscope-assisted and endoscope-assisted groups. SETTING: Kyoto University Hospital, Kyoto, Japan. METHODS: This retrospective nonrandomized study comprised 121 eyes of 115 patients who had transscleral sulcus suture fixation of an IOL by the ab externo method. Typical 3-port vitrectomy was performed in 26 eyes in which the needle entry site and the haptic location were controlled using an endoscope. RESULTS: During follow-up of at least 3 months, surgical complications in the nonendoscope-assisted group (95 eyes) included IOL dislocation in 22 eyes (23%), high astigmatism in 12 eyes (13%), transient ocular hypertension in 10 eyes (11%), vitreous hemorrhage in 5 eyes (5.3%), retinal detachment in 4 eyes (4.2%), and cystoid macular edema in 2 eyes (2.0%). In the endoscope-assisted group (26 eyes), the same complications were markedly decreased: there were no cases of IOL dislocation, high astigmatism, vitreous hemorrhage, retinal detachment, or cystoid macular edema; transient ocular hypertension occurred in 1 eye (3.8%). There was a statistically significant difference in the incidence of IOL dislocation between the 2 groups (P<.01). CONCLUSION: Using an endoscope for transscleral sulcus suturing of an IOL can be an effective technique to reduce surgical complications, especially postoperative IOL dislocation.     

Surgical technique for transscleral fixation of a foldable posterior chamber intraocular lens.

The safety and efficacy of a modified technique for transscleral fixation of a foldable posterior chamber intraocular lens (IOL) for intracapsular aphakia (secondary IOL) or after complicated phacoemulsification was evaluated. All eyes had inadequate or no posterior capsular support. Follow-up was between 4 and 26 months (mean, 12 months). Uncorrected visual acuity improved (> 2 lines) in all patients. During follow-up, the IOL was correctly positioned in all cases. There were no major complications, such as endophthalmitis or suture erosion through the conjunctiva at the site of fixation. No patient required further surgical interventions. This modified technique of transscleral fixation of foldable posterior chamber IOL offers the advantages of a small incision and rapid visual rehabilitation, and minimizes the risk of intraoperative and postoperative complications.     

微小切口推注式人工晶状体睫状沟悬吊术临床应用

目的:探讨微小切口推注式折叠人工晶状体睫状沟悬吊术的有效性和安全性。方法:选择因晶状体后囊破裂或悬韧带断裂不能正常植入后房型人工晶状体的患者52例52眼,利用推注器系统,通过3.2mm的透明角膜小切口,把襻预扎了聚丙烯缝线的折叠人工晶状体植入后房并缝合固定于睫状沟,观察术后视力、角膜散光度及并发症。结果:所有患者术后裸眼视力均提高,其中1.0以上8眼,0.6～0.8为18眼,0.4～0.6为16眼,0.4以下10眼。术后1wk;1,3mo视力在0.5以上者分别为33眼(63%)、39眼(75%)、41眼(79%)。术前及术后1wk;1,3mo的平均角膜散光度分别为1.86±1.65D,2.09±1.28D,1.92±1.34D和1.77±1.16D,术后各时期与术前的角膜散光度差别均无统计学意义(P>0.05)。术中、术后没有出现严重并发症。结论:微小切口推注式折叠人工晶状体睫状沟悬吊术为治疗晶状体、玻璃体切除术后,无晶状体囊支持的患者,提供了一个更安全可靠的人工晶状体植入方法。     

Pupillary capture following sutureless scleral-fixated intraocular lens in children with Marfan syndrome

AIM: To compare the clinical outcomes between two approaches for sutureless scleral-fixated intraocular lens (SFIOL) in children with Marfan syndrome (MFS). METHODS: The study included 15 children (26 eyes) with lens subluxation due to MFS. These children underwent lensectomy, anterior vitrectomy, and sutureless SFIOL. According to the position of placement of intraocular lens (IOL) haptics, two study groups were reviewed for best corrected visual acuity (BCVA) and postoperative complications: group A, 14 eyes with haptics fixated at 2.0 mm from the limbus; group B, 12 eyes with the haptics fixated at 2.5 mm from the limbus. RESULTS: The mean axial length for all patients was 25.66±2.35 mm. Postoperative BCVA in logMAR were significant improved in both groups (0.77±0.32 to 0.17±0.12 in group A, 0.66±0.25 to 0.24±0.12 in group B, both P<0.001) while no significant difference between two groups (P>0.05). Pupillary capture was main postoperative complication, occurring between 3d and 18mo. It occurred in 7 eyes in group A and one eye in group B (P=0.02). CONCLUSION: Sutureless SFIOL is an effective treatment approach for lens subluxation in children with MFS. Pupillary capture is the main postoperative complication. Fixated IOL haptics at 2.5 mm from the limbus can reduce the occurrence of pupillary capture.     

Sutureless Intrascleral Pocket Technique of Transscleral Fixation of Intraocular Lens in Previous Vitrectomized Eyes

In this case series, we assessed a new technique, the intrascleral pocket procedure of transscleral fixation (TF) of the intraocular lens (IOL) in post-vitrectomized eyes. We performed the transscleral fixation of IOL in four aphakic patients who underwent pars plana vitrectomy. Two points 180° apart were marked at the limbus. A 2-mm-sized intrascleral pocket was created by lamellar dissection using a crescent blade without conjunctival dissection. A 2.8-mm clear corneal incision (CCI) was made using a keratome. Prolene sutures were exteriorized through the CCI pocket and a three-piece foldable acrylic IOL was injected via CCI and the ends of the haptics were exteriorized through the CCI. The prolene sutures for each haptic in the intrascleral pocket bed were then tied and knots were buried under scleral flaps. No patient had complaints such as conjunctival irritation, and visual acuity was almost identical to preoperative best-corrected visual acuity at day 1 postoperatively. IOLs were well placed without tilting or subluxation. They had no wound dehiscence or endophthalmitis postoperatively. The intrascleral pocket procedure of TF without the need for conjunctival dissection is a successful method for sulcus fixation in post-vitrectomized eyes predisposed to developing glaucoma.     

Modified transscleral fixation technique for refixation of dislocated intraocular lenses

PURPOSE: To evaluate the results of transscleral fixation of dislocated posterior chamber intraocular lenses (PC IOLs) by externalizing the haptics through a clear corneal incision. SETTING: Department of Ophthalmology, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. METHODS: This retrospective interventional case series comprised 21 eyes (21 patients) in which a dislocated posterior chamber IOL was transsclerally refixated using a small superior clear corneal incision for externalization of the haptics. The suture was tied to the externalized haptic, after which the tied haptic was placed back in the anterior chamber and dialed to externalize the second haptic. After the second externalized haptic was tied, the IOL was reimplanted in the ciliary sulcus. The minimum follow-up was 6 months. RESULTS: The mean follow-up was 42.7 months +/- 21 (SD). The difference between the mean best corrected visual acuity before IOL dislocation (0.34 +/- 0.21 logMAR) and the mean after IOL refixation (0.38 +/- 0.19 logMAR) was not statistically significant (P = .16, t test). During follow-up, the PC IOL remained well centered in all eyes and no tilt or dislocation was observed. CONCLUSION: Scleral fixation of dislocated PC IOLs using temporary haptic externalization through a clear corneal incision minimized the need for complicated intraocular maneuvers, had a low incidence of complications, and provided an easy and effective way to reposition dislocated PC IOLs.     

一种改良微创人工晶状体固定术的临床观察

目的：观察隐形锚钩式巩膜层间人工晶状体固定术的临床效果。

方法：前瞻性非对照性病例研究。选取2019-01/2020-12我院收治的无晶状体、人工晶状体脱位或晶状体脱位患者19例19眼,所有患者均接受锚钩式人工晶状体巩膜层间固定植入手术。观察手术前后最佳矫正视力(BCVA)、裸眼视力(UCVA)、角膜内皮细胞密度、术后人工晶状体位置有无倾斜和并发症。

结果：术前和术后1 mo ,UCVA(LogMAR)为1.06±0.63和0.40±0.26(P<0.01),BCVA(LogMAR)为0.27±0.51和0.06±0.15(P=0.09),角膜内皮细胞密度为2406±625和2004±759 cells/mm²(P=0.13)。术后1d房水闪辉2级或以上3眼,角膜后弹力层皱褶2眼,一过性眼压升高2眼。随访24 mo均未发生人工晶状体脱位。

结论：锚钩式人工晶状体巩膜层间固定技术,组织间线头顺行进入-逆向固定,类似锚钩原理,达到了良好的人工晶状体稳定性和视觉效果。     

Ultrasound biomicroscopic analysis of posterior chamber intraocular lenses with transscleral sulcus suture

OBJECTIVE: To investigate the postoperative problems of intraocular lenses (IOLs) with transscleral sulcus suture. DESIGN: Retrospective observational case series. PARTICIPANTS: Forty-one subjects (43 eyes) were included. INTERVENTION: All eyes had undergone transscleral sulcus suture of IOLs. Surgeries were all performed by surgeons in our clinic using the same technique. MAIN OUTCOME MEASURES: Ultrasound biomicroscopy of the suture sites, their surrounding structures, and central anterior chamber depth. Other parameters studied included visual acuity, aqueous flare, and routine ophthalmic examinations. RESULTS: Thirty-two of 86 haptics were sutured at the ciliary sulcus (CS) region and 29 at the ciliary process region, which was the space between CS and pars plicata, and 25 posterior to pars plicata. We designated the cases with at least one haptic located in the CS region as the anterior group, and the other cases as the posterior group. In the anterior group, anterior chamber depth was significantly more shallow than in the fellow eye in which IOLs were fixed in the bag (P = 0.049). There was a statistically greater incidence of IOL iris contact in the anterior group than in the posterior group (P = 0.00057). Pigment dispersion was seen in seven cases, all of which were classified as anterior group. Eyes in the posterior group had more aqueous flare than their fellow eyes (P = 0.014). Two cases, in which more than two lines of postoperative best-corrected visual acuity was lost because of macular degeneration after cystoid macular edema, showed marked elevation of aqueous flare in the sutured eyes compared with their fellow eyes. Forty-one of 86 haptics had vitreous incarceration. CONCLUSIONS: This technique has many limitations: the difficulty of suturing precisely at the ciliary sulcus, IOL iris contact, pigment dispersion, high aqueous flare, and vitreous incarceration. These induce two major postoperative complications: chronic inflammation and influence on the adjacent vitreous such as vitreous incarceration. The suturing technique and instruments need to be improved to diminish such complications.     

Double-knot transscleral suture fixation technique for displaced intraocular lenses

PURPOSE: To describe a simplified new technique for repositioning and attaching a suture to the haptic of a displaced posterior chamber intraocular lens (IOL). METHODS: We describe a double-knot technique for repositioning and transscleral suture fixation of a subluxed posterior chamber IOL after penetrating keratoplasty. Two 10-0 Prolene transscleral sutures on straight needles are passed around the IOL haptic, tied extraocularly, and used to secure the repositioned haptic of the IOL. A second knot ties the transscleral suture in the scleral bed, stabilizing the haptic in the ciliary sulcus. RESULTS: In the case described, the IOL was stable and well positioned 2 months after surgery. CONCLUSION: The double-knot technique for intraocular repositioning and transscleral suture fixation of displaced posterior chamber IOLs reduces the extensive intraocular manipulation and scleral incisions required for IOL exchange and may reduce chronic irritation associated with iris fixation.     

无缝线巩膜层间固定术和传统睫状沟缝线悬吊术后患者人工晶状体位置特征及其与预后视力的关系

目的　对比分析无缝线巩膜层间固定术和传统睫状沟缝线悬吊术后患者人工晶状体位置特征及与预后视力的关系。方法　选取2017年5月至2019年9月在我院行后房型人工晶状体无缝线巩膜层间固定术的患者13例（14眼）作为层间固定术组;另外,选取行后房型人工晶状体睫状沟缝线悬吊术的患者13例（14眼）作为缝线悬吊术组。两组患者性别构成、年龄、术前裸眼视力（UCVA）和最佳矫正视力（BCVA）差异均无统计学意义（均为P>0.05）。检查并比较两组患者术前及术后UCVA和BCVA、屈光状态,并应用全景超声生物显微镜观察术后患者人工晶状体水平、垂直位的倾斜度和偏心值,采用Pearson相关分析进行晶状体位置参数和术后UCVA、BCVA、散光度和等效球镜度的相关性分析。结果　术后6个月,层间固定术组和缝线悬吊术组患者UCVA均较术前1周显著提高（均为P<0.05）;两组患者BCVA均较术前1周有所提高,但差异均无统计学意义（均为P>0.05）。术后6个月,28眼人工晶状体水平倾斜度为2.28°± 1.89°,水平偏心值为（1.56±1.23）mm,垂直倾斜度为4.32°± 4.61°,垂直偏心值为（1.82 ± 1.46）mm。术后6个月,层间固定术组患者人工晶状体垂直偏心值较缝线悬吊术组大,差异有统计学意义（P=0.01）;两组患者人工晶状体水平倾斜度、水平偏心值、垂直倾斜度比较,差异均无统计学意义（均为P>0.05）。术后6个月,层间固定术组患眼的垂直倾斜度大于水平倾斜度,差异有统计学意义（P=0.01）。所有患者人工晶状体位置参数与预后视力各指标间均无相关性(均为P>0.05)。术前28眼眼压均在正常范围;术后3个月层间固定术组1眼眼压为8.0～8.8 mmHg（1 kPa=7.5 mmHg),处于偏低状态;经局部应用激素滴眼治疗后6个月眼压稳定至正常。结论　无缝线巩膜层间固定术能使患者获得较好的预后视力,与传统睫状沟缝线悬吊术效果相似。     

后房型人工晶状体巩膜层间固定术后屈光状态研究

目的:研究后房型人工晶状体(IOL)巩膜层间固定术后屈光状态。方法:回顾性临床研究。选取2017-03/2021-12于北京大学国际医院行后房型IOL巩膜层间固定术的患者55例55眼。根据手术步骤不同分为常规组(35眼)及改良组(20眼)。应用IOL Master光学生物测量仪及SRK/T公式计算IOL屈光度及预留屈光度,记录术前角膜散光值。术后1、3mo行验光,IOL Master光学生物测量仪及Pentacam眼前段分析仪检查,记录术后角膜散光及总散光值,计算等效球镜度数作为实际屈光度。采用Image-pro plus图像分析软件计算IOL倾斜度及偏心值。结果:患者55眼后房型IOL巩膜层间固定术后呈现远视漂移,术后3mo患者屈光误差为0.75±0.63D。术后3mo实际屈光度与术前预留屈光度有差异(t=2.553,P=0.011)。无论常规组或改良组,术后均表现为远视漂移。常规组术后1、3mo屈光误差为0.80±0.43、0.84±0.46D,改良组术后1、3mo屈光误差为0.43±0.39、0.47±0.26D,两组间比较均有差异(1mo:t=3.500,P=0.001;3mo...     

Comparison of Artisan iris-claw intraocular lens implantation and posterior chamber intraocular lens sulcus fixation for aphakic eyes

AIM: To compare the efficacy and complications of Artisan iris-claw intraocular lens (IOL) implantation and posterior chamber IOL sulcus fixation for the treatment of aphakic eyes without capsular support after vitrectomy.METHODS:A prospective study of 45 cases was conducted. Forty-five eyes without sufficient lens capsule support following pars plana vitrectomy (PPV) combined lens extraction were divided into two groups. Group A:25 eyes received Artisan iris-claw IOL implantation. Group B:20 eyes received posterior chamber IOL sulcus fixation. The corrected distance visual acuity (CDVA) and intraocular pressure (IOP), corneal endothelial cell loss rate, surgical time and complications were compared between the two groups. Pigment changes of trabecular meshwork and anterior chamber depths were measured at each time point in Artisan group.RESULTS:The mean surgical time of Artisan group was significantly shorter (P<0.05). No statistically significant difference in endothelial cell loss rate was noted between two groups at any time point (P>0.05). CDVA of Artian group was better than that of the sulcus fixation group 1d after surgery (P<0.05) and there was no statistically significant difference 1 and 3mo after surgery (P>0.05). Mean IOP showed no significant differences between groups before and after surgery. The postoperative complications of Artisan group were anterior uveitis, iris depigmentation, pupillary distortion and spontaneous lens dislocation. The complications of sulcus fixation group include choroidal detachment, intraocular haemorrhage, tilt of IOL optic part and retinal detachment.CONCLUSION:Secondary Artisan IOL implantation can be performed less invasively and in a shorter surgical time period with earlier visual recovery after surgery compared to transscleral suturing fixation of an IOL. This technique is an effective and safe procedure. It is a promising option for the treatment of aphakic eyes without capsular support after vitrectomy.