关键词: 人工晶状体脱位, 黄斑囊样水肿, 曲安奈德

Abstract: Objective To explore the effect of retrobulbar triamcinolone acetonide (TA) after pars planavitrectomy （PPV）combined with intraocular lens (IOL) fixation for IOL dislocation with cystoid macular edema（CME）. Design Retrospective case series. Participants 19 patients (19 eyes) with IOL dislocation and CME were included from January 2020 to January 2024 in Beijing Tongren Hospital. Methods All cases underwent routine ophthalmic examination before surgery, including uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA), intraocular pressure (IOP), fundus examination, fundus fluorescein angiography, OCT and central macular thickness (CMT) measurement. The surgical methods for all included eyes were vitrectomy combined with IOL fixation，and TA (20 mg) retrobulbar injection after the surgery immediately. All patients underwent routine postoperative follow-up at 1, 3, 7 days, 1, 3 months and above after surgery. Main Outcome Measures BCVA, IOP, CMT, recurrence of CME, and complications. Results The postoperative follow-up time was (7.05±3.26) months (4-15 months). BCVA(LogMAR) at 1 month, 3 months after surgery, and final follow-up was (0.11±0.09), (0.07±0.13), (0.09±0.19), compared with the preoperative BCVA(LogMAR) (0.52±0.21), which was all significantly decreased (all P<0.001). The IOP at 1 month, 3 months after surgery, and final follow-up was (18.06±3.11) mmHg, (17.61±2.17) mmHg, (17.00±2.93) mmHg, compared with the preoperative IOP (16.94±3.42) mmHg, which was all without significant difference. The CMT at 1 month, 3 months after surgery, and the last follow-up was (289.84±37.30) μm, (295.16±107.75) μm, (300.53±125.37) μm, compared with that before surgery (451.47±140.71) μm, which was all significantly decreased (all P<0.001). The CME in 15.8% (3/19 cases) reappeared at least 1 time during the follow-up. No serious complications such as vitreous hemorrhage, retinal detachment, infectious endophthalmitis, and IOL redislocation occurred in all the eyes during surgery and follow-up. The incidence of intraocular hypertension was 5.3% (1/19 cases) 1 month after surgery, and the IOP of this eye was normal 3 months after surgery. Conclusion Retrobulbar TA injection after the vitrectomy combined with IOL fixation is a safe and effective treatment for IOL dislocation with CME. (Ophthalmol CHN, 2024, 33: 301-306)

Key words:  intraocular lens dislocation, cystoid macular edema, triamcinolone acetonide