白内障手術後の眼内レンズ脱臼に対する強膜支持のための新規三角縫合テクニックの評価：後ろ向きコホート研究

This study evaluates the safety and efficacy of a novel triangular suture technique (TST) as an alternative method to scleral-fixated intraocular lens implantation in patients with intraocular lens (IOL) dislocation following cataract surgery. The aim is to assess visual outcomes, intraocular pressure (IOP) control, and complication rates over an extended follow-up period. A retrospective cohort study analyzed 43 patients (48.8% female; mean age 77.9 ± 10.3 years) who underwent scleral-supported IOL implantation using the TST. Preoperative assessments included ocular history, baseline visual acuity, and IOP. Postoperative follow-up was conducted at 6 defined intervals over 26 months. All surgeries were performed using a uniform triangular scleral suture approach with 10-0 polypropylene in a three-point support pattern. Sutures were placed 3.0 mm posterior to the limbus at 11, 7, and 3 o'clock positions (corresponding to the triangular configuration), with subconjunctival passage between designated clock-hour positions to prevent erosion and ensure proper IOL centration. Outcome measures included uncorrected visual acuity, best-corrected visual acuity, IOP, glaucoma medication requirements, and central macular thickness. Uncorrected visual acuity improved significantly from 0.92 ± 0.55 to 0.50 ± 0.40 logarithm of the minimum angle of resolution (logMAR) at 6 months (P < .01). Best-corrected visual acuity improved significantly from 0.75 ± 0.34 to 0.36 ± 0.42 logMAR at 6 months (P < .01) and was maintained at 0.37 ± 0.50 logMAR at 26 months (P < .01). A transient IOP rise was observed on the first postoperative day (mean 18.14 ± 5.65 mm Hg; P < .05), with normalization thereafter. No significant complications were observed over the 24-month follow-up period. The TST provides a safe and effective alternative to conventional scleral-fixated intraocular lens fixation methods, offering significant and sustained visual improvement, minimal complications, excellent IOL stability, and stable anatomical outcomes over extended follow-up.