Amino K, Yamakawa R
Department of Ophthalmology, Tenri Yorozu Hospital, Japan.
J Cataract Refract Surg. 2000 Feb;26(2):266-70. doi: 10.1016/s0886-3350(99)00345-4.
To evaluate long-term results of out-of-the-bag intraocular lens (IOL) implantation.
Department of Ophthalmology, Tenri Yorozu Hospital, Nara, Japan.
This study comprised 22 patients, 13 women and 9 men, who had cataract surgery by phacoemulsification and out-of-the-bag IOL implantation because of a posterior lens capsule rupture. Sixteen patients had in-the-bag IOL implantation in the fellow eye, and these eyes were used as a control group. The IOL's position was determined by ultrasound biomicroscopy (UBM). Anterior chamber flare counts were measured by a laser flare meter. The corneal endothelium was observed by specular microscopy.
Mean follow-up after cataract surgery was 35 months +/- 22 (SD). The UBM revealed that in the 19 eyes with sulcus-to-sulcus IOL fixation, the optics touched the iris. In 3 eyes, 1 haptic was fixated at the sulcus and the other at the ciliary body. In 2 of these eyes, the optics did not touch the iris. Anterior chamber flare counts in eyes with sulcus-to-sulcus IOL fixation were significantly higher than in eyes with in-the-bag or sulcus-to-ciliary-body fixation (P < .05). There were no statistical differences in corneal endothelial cell counts based on haptic placement.
Rubbing between the IOL optic and iris seems to contribute to the high flare counts in eyes with a sulcus-to-sulcus IOL fixation. A larger haptic angle may be needed to prevent contact between the iris and IOL optic in such cases.
评估囊外人工晶状体(IOL)植入的长期效果。
日本奈良天理万代医院眼科。
本研究纳入22例患者,其中女性13例,男性9例,因晶状体后囊破裂接受了白内障超声乳化吸除术及囊外IOL植入术。16例患者的对侧眼接受了囊内IOL植入,这些眼作为对照组。通过超声生物显微镜(UBM)确定IOL的位置。使用激光散射仪测量前房闪光计数。通过镜面显微镜观察角膜内皮。
白内障手术后的平均随访时间为35个月±22(标准差)。UBM显示,在19只采用沟到沟IOL固定的眼中,光学部接触虹膜。在3只眼中,1个袢固定在沟内,另1个袢固定在睫状体上。在其中2只眼中,光学部未接触虹膜。采用沟到沟IOL固定的眼的前房闪光计数显著高于采用囊内或沟到睫状体固定的眼(P <.05)。基于袢的放置位置,角膜内皮细胞计数无统计学差异。
IOL光学部与虹膜之间的摩擦似乎是导致采用沟到沟IOL固定的眼闪光计数较高的原因。在这种情况下,可能需要更大的袢角度来防止虹膜与IOL光学部接触。