Neuhann Irmingard M, Werner Liliana, Izak Andrea M, Pandey Suresh K, Kleinmann Guy, Mamalis Nick, Neuhann Thomas F, Apple David J
David J. Apple, MD Laboratories for Ophthalmic Devices Research, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah 84132, USA.
Ophthalmology. 2004 Nov;111(11):2094-101. doi: 10.1016/j.ophtha.2004.06.032.
To report clinical, pathologic, histochemical, ultrastructural, and spectroscopic analyses of MemoryLens intraocular lenses (IOLs) explanted from patients who had visual disturbances caused by postoperative opacification of the lens optic.
Noncomparative, large case series with clinicopathologic correlation.
A total of 106 hydrophilic acrylic IOLs of the same design explanted from 106 different patients. All patients had decreased visual acuity at presentation approximately 2 years after cataract surgery, associated with a whitish fine granularity on the optical surfaces of the IOLs.
The explanted IOLs were submitted to the John A. Moran Eye Center and were examined under light microscopy, histochemically, and with scanning electron microscopy (SEM) equipped with an energy dispersive x-ray spectroscopy detector with light element capabilities (EDS).
The IOLs were examined for distribution, structure, and composition of the deposits causing opacification of their optic components.
The average interval between lens implantation and opacification was 25.8+/-11.9 months. The most frequently associated medical and ophthalmic conditions were diabetes and glaucoma. However, some patients did not have any preexisting medical or ophthalmic conditions. Most of the IOLs had been implanted in 1999 and 2000. Microscopic analyses revealed the presence of multiple fine, granular deposits of variable sizes on the anterior and posterior optic surfaces, especially on the anterior surface. The deposits stained positive for calcium. The EDS confirmed the presence of calcium and phosphate within the deposits.
The results obtained suggest the surface deposits to be composed, at least in part, by calcium and phosphate. A special polishing technique used in the manufacture of most of these IOLs may have caused changes in the lens surface leading to deposit formation. Further studies should be undertaken to confirm this hypothesis.
报告对因人工晶状体光学部术后混浊导致视力障碍的患者所植入的MemoryLens人工晶状体（IOL）进行的临床、病理、组织化学、超微结构和光谱分析。
具有临床病理相关性的非对照大病例系列。
从106例不同患者中取出的106枚相同设计的亲水性丙烯酸酯IOL。所有患者在白内障手术后约2年就诊时视力下降，且IOL光学表面有白色细颗粒状物。
将取出的IOL送至约翰·A·莫兰眼科中心，进行光学显微镜检查、组织化学检查以及配备有具备轻元素分析能力的能量色散X射线光谱探测器的扫描电子显微镜（SEM）检查。
检查IOL上导致其光学部件混浊的沉积物的分布、结构和成分。
晶状体植入与混浊之间的平均间隔为25.8±11.9个月。最常伴发的内科和眼科疾病为糖尿病和青光眼。然而，一些患者没有任何既往内科或眼科疾病。大多数IOL于1999年和2000年植入。显微镜分析显示，在光学部的前表面和后表面存在多个大小不一的细小颗粒状沉积物，尤其是在前表面。沉积物钙染色呈阳性。EDS证实沉积物中存在钙和磷酸盐。
所获得的结果提示表面沉积物至少部分由钙和磷酸盐组成。大多数此类IOL制造过程中使用的一种特殊抛光技术可能导致晶状体表面发生变化，从而导致沉积物形成。应开展进一步研究以证实这一假说。
