Purpose

To report a series of patients who developed neurotrophic keratopathy following scleral fixation of intraocular lenses.

Methods

Retrospective case series of patients undergoing implantation of scleral fixated IOLs with various techniques.

Results

Three patients developed NK in the immediate post-operative period following scleral fixation of IOLs. Scleral fixation of IOL was performed using three different techniques (4-point fixation, “Yamane” flanged intrascleral and tunneled intrascleral haptic fixation). None of the patient had any prior risk factors for the development of NK. In all patients, intrascleral haptics or scleral sutures were positioned on the horizontal meridian. All patients also underwent light peripheral retinal endolaser.

Conclusions

NK can rarely occur following scleral fixation of IOLs. The combination of suturing or intrascleral fixation of the IOL on the horizontal meridian and peripheral retinal endolaser may synergistically damage to the long ciliary nerves with a “two-hit” mechanism and cause NK.

中文翻译：

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神经营养性角膜病变作为巩膜固定人工晶状体植入的并发症

目的

报告一系列在人工晶状体巩膜固定后发生神经营养性角膜病变的患者。

方法

采用各种技术进行巩膜固定人工晶状体植入的患者的回顾性病例系列。

结果

3 名患者在 IOL 巩膜固定后的术后即刻发生 NK。IOL 的巩膜固定采用三种不同的技术（4 点固定、“Yamane”法兰式巩膜内和隧道式巩膜内触觉固定）。没有任何患者有任何先前发生 NK 的危险因素。在所有患者中，巩膜内触觉或巩膜缝合线均位于水平子午线上。所有患者还接受了光外周视网膜内皮激光。

结论

IOL 巩膜固定后很少发生 NK。水平子午线和周围视网膜内激光缝合或巩膜内固定IOL可能以“双击”机制协同损伤长睫状神经并引起NK。