Braga-Mele R, Cohen S, Rootman D S
University of Toronto, Toronto Hospital (Western Division), Toronto, Ontario, Canada.
J Cataract Refract Surg. 2000 Oct;26(10):1517-22. doi: 10.1016/s0886-3350(00)00478-8.
To compare the outcome of phacotrabeculectomy with implantation of poly(methyl methacrylate) (PMMA) or foldable silicone intraocular lenses (IOLs).
Thirty patients were randomized to receive a 5.5 mm PMMA IOL through a 5.0 mm incision or a foldable silicone IOL (Allergan SI-30) through a 3.2 mm incision. Visual acuity, intraocular pressure (IOP), bleb survival, inflammation, endothelial cell changes, and complications were examined at intervals up to 6 months.
There was no difference between the 2 groups in final visual outcome, final IOP control, bleb survival, and endothelial cell changes. Two months after surgery, there was significantly more inflammation in the silicone IOL group than in the PMMA group (P <. 05). The silicone group had a significantly higher combined complication rate including iris capture, choroidal effusion, and epiretinal membrane formation (P <.05).
Foldable silicone IOLs were comparable to conventional PMMA lenses in visual outcome, IOP control, bleb formation, and endothelial changes. However, some silicone lenses are associated with an increased risk of recurrence of inflammation and a higher final complication rate in combined cataract and filtration surgery.
比较白内障小梁切除术联合植入聚甲基丙烯酸甲酯（PMMA）人工晶状体或可折叠硅胶人工晶状体（IOL）的效果。
30例患者被随机分为两组，一组通过5.0mm切口植入5.5mm PMMA人工晶状体，另一组通过3.2mm切口植入可折叠硅胶人工晶状体（爱尔康SI-30）。在长达6个月的时间内定期检查视力、眼压（IOP）、滤过泡存活情况、炎症反应、内皮细胞变化及并发症。
两组在最终视力结果、最终眼压控制、滤过泡存活情况及内皮细胞变化方面无差异。术后2个月，硅胶人工晶状体组的炎症反应明显多于PMMA组（P<.05）。硅胶组的联合并发症发生率明显更高，包括虹膜嵌顿、脉络膜渗漏和视网膜前膜形成（P<.05）。
在视力结果、眼压控制、滤过泡形成及内皮细胞变化方面，可折叠硅胶人工晶状体与传统PMMA人工晶状体相当。然而，在白内障联合滤过手术中，一些硅胶人工晶状体与炎症复发风险增加及最终并发症发生率较高有关。
