Werner L, Apple D J, Kaskaloglu M, Pandey S K
Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina 29425-5536, USA.
J Cataract Refract Surg. 2001 Sep;27(9):1485-92. doi: 10.1016/s0886-3350(01)00841-0.
To report clinical, pathological, histochemical, ultrastructural, and spectrographic analyses of explanted hydrophilic acrylic intraocular lenses (IOLs) obtained from patients who had visual disturbances caused by postoperative opacification of the lens optic.
Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA, and Ege University, Alsancak Izmir, Turkey.
Nine hydrophilic IOLs (SC60B-OUV, MDR Inc.) were explanted from 9 patients with decreased visual acuity. Most patients became symptomatic approximately 24 months after uneventful phacoemulsification and IOL implantation. Opacification was noted and appeared clinically to be associated with a fine granularity within the substance of the IOL optic. The IOLs were forwarded to the center and examined by gross and light microscopy. Full-thickness cut sections of the optics were stained with 1% alizarin red and the von Kossa method (special stains for calcium). Some were submitted for scanning electron microscopy and energy dispersive x-ray spectroscopy.
Microscopic analyses revealed multiple fine, granular deposits of variable sizes within the lens optics, usually distributed in a line parallel to the anterior and posterior curvatures of the optic, with a clear zone just beneath the optic surface. The deposits stained positive with alizarin red and the von Kossa method. Energy dispersive x-ray spectroscopy of the internal substance of sectioned IOLs demonstrated the presence of calcium within the deposits.
This is the first clinicopathological report of optic opacification occurring with this hydrophilic acrylic IOL model. Studies of similar cases with this lens should be done to determine the incidence and possible mechanisms of the phenomenon.
报告对因人工晶状体光学部术后浑浊导致视力障碍的患者所取出的亲水性丙烯酸人工晶状体（IOL）进行的临床、病理、组织化学、超微结构及光谱分析。
美国南卡罗来纳州查尔斯顿市南卡罗来纳医科大学风暴眼研究所眼治疗与生物装置研究中心，以及土耳其伊兹密尔阿尔桑卡克的埃杰大学。
从9例视力下降的患者眼中取出9枚亲水性IOL（SC60B - OUV，MDR公司）。大多数患者在白内障超声乳化吸除联合IOL植入术后约24个月出现症状。观察到浑浊，临床显示与IOL光学部物质内的细微颗粒有关。将IOL送至该中心，进行大体及光学显微镜检查。光学部的全层切片用1%茜素红和冯·科萨法（钙的特殊染色法）染色。部分标本进行扫描电子显微镜及能量色散X射线光谱分析。
显微镜分析显示晶状体光学部内有多个大小不一的细微颗粒状沉积物，通常沿与光学部前后曲率平行的方向呈线状分布，光学部表面下方有一清晰区域。沉积物经茜素红和冯·科萨法染色呈阳性。对切开的IOL内部物质进行能量色散X射线光谱分析显示沉积物中存在钙。
这是关于这种亲水性丙烯酸IOL模型发生光学部浑浊的首篇临床病理报告。应对使用该晶状体的类似病例进行研究，以确定该现象的发生率及可能机制。
