Dick H B, Tehrani M, Brauweiler P, Haefliger E, Neuhann Th, Scharrer A
Universitäts-Augenklinik, Langenbeckstrasse 1, 55131 Mainz.
Ophthalmologe. 2002 Jun;99(6):438-43. doi: 10.1007/s00347-001-0574-9.
A questionnaire was sent to all members of the German Society of Ophthalmic Surgeons to evaluate complications of foldable intraocular lenses (IOLs) that required explanation.
Information on preoperative visual acuity, foldable IOL design and material as well as the reason for IOL explantation was obtained and analysed. We received 167 completed questionnaires for 1998 and 1999.
In 1998 and 1999 the most common reasons for IOL explantation were as follows: incorrect lens power for 56% of the 3-piece hydrophobic acrylic IOLs, 16% because of glare or other photic phenomena, 40% of the 1-piece hydrophilic acrylic IOLs were explanted because of incorrect lens power and 30% for IOL damage. For the 3-piece monofocal silicone IOLs, 41% were explanted because of incorrect IOL power and 32% because of IOL decentration. For the 1-piece Hydrogel IOL, 76% were explanted because of opacification of the optic and 14% because of incorrect lens power. Most multifocal IOLs were explanted because of photic phenomena.
In addition to the most common complications such as decentration and incorrect IOL power observed in rigid IOLs, new complications associated with foldable IOLs occurred such as optic opacification, glare and photic phenomena. Some complications seemed to appear in particular IOL types (opacification: SC-60BOUV, MDR), while others were observed in all types of foldable lenses. Accurate calculation of the IOL power and further improvement of the IOL material and design seem to be necessary to minimise the rate of explantations.
向德国眼科外科医生协会的所有成员发送了一份问卷,以评估需要解释的可折叠人工晶状体(IOL)并发症。
获取并分析了术前视力、可折叠IOL设计和材料以及IOL取出原因等信息。我们收到了1998年和1999年的167份完整问卷。
1998年和1999年IOL取出的最常见原因如下:三件式疏水丙烯酸IOL中56%是因为晶状体屈光度不正确,16%是由于眩光或其他光现象,一件式亲水丙烯酸IOL中40%因晶状体屈光度不正确而被取出,30%是因为IOL损坏。对于三件式单焦点硅胶IOL,41%因IOL屈光度不正确而被取出,32%是因为IOL偏心。对于一件式水凝胶IOL,76%因光学部混浊而被取出,14%是因为晶状体屈光度不正确。大多数多焦点IOL因光现象而被取出。
除了在硬性IOL中观察到的最常见并发症如偏心和IOL屈光度不正确外,还出现了与可折叠IOL相关的新并发症,如光学部混浊、眩光和光现象。一些并发症似乎在特定的IOL类型中出现(混浊:SC - 60BOUV、MDR),而其他并发症在所有类型的可折叠晶状体中都有观察到。准确计算IOL屈光度以及进一步改进IOL材料和设计似乎对于降低取出率是必要的。