Werner Liliana, Kollarits Carol R, Mamalis Nick, Olson Randall J
John A. Moran Eye Center, University of Utah, Salt Lake City, Utah 84132, USA.
Ophthalmology. 2005 Mar;112(3):447-52. doi: 10.1016/j.ophtha.2004.10.025.
To illustrate the laboratory findings in a patient with bilateral asteroid hyalosis who presented with calcified deposits on a 3-piece silicone intraocular lens (IOL).
Observational case report.
A 76-year-old diabetic woman underwent uneventful cataract surgery in 1994 with implantation of a silicone-optic polypropylene-haptic IOL in the left eye. A neodymium:yttrium-aluminum-garnet (Nd:YAG) laser posterior capsulotomy was performed 2 years after cataract surgery, but persistent whitish deposits were observed on the posterior optic surface of the lens. Over the next 3 years, the opacification increased in the region corresponding to the capsulotomy. The IOL was explanted/exchanged. The right eye had cataract surgery in 1995. The acrylic lens implanted in this eye developed no opacities after 6 years.
Gross, microscopic, and surface analyses of the explanted IOL.
Gross and light microscopic analyses revealed the presence of confluent crustlike deposits on the central area of the posterior optic surface, as well as Nd:YAG pits. Individual spherules exhibiting a Maltese-cross pattern under polarizing light were also observed. Energy dispersive x-ray spectroscopic analyses demonstrated the composition of the confluent deposits to be similar to hydroxyapatite.
An association between asteroid hyalosis and dystrophic calcification of IOLs has been reported only with silicone plate haptic designs. The material opacifying the 3-piece silicone lens probably was derived from the asteroid bodies or from the process that results in this vitreous condition. Clinical evaluation of other pseudophakic patients with asteroid hyalosis will confirm if this phenomenon is restricted to silicone IOLs.
阐述一例双侧星状玻璃体病变患者的实验室检查结果，该患者植入的三片式硅胶人工晶状体（IOL）上出现了钙化沉积物。
观察性病例报告。
一名76岁的糖尿病女性于1994年接受了左眼白内障手术，手术顺利，并植入了硅胶光学部-聚丙烯襻人工晶状体。白内障手术后2年进行了钕:钇铝石榴石（Nd:YAG）激光后囊切开术，但在晶状体后光学表面观察到持续的白色沉积物。在接下来的3年里，与囊切开术对应的区域混浊加重。该人工晶状体被取出/更换。右眼于1995年进行了白内障手术。植入该眼的丙烯酸晶状体6年后未出现混浊。
取出的人工晶状体的大体、显微镜和表面分析。
大体和光学显微镜分析显示，后光学表面中央区域存在融合的痂状沉积物以及Nd:YAG激光打孔痕迹。在偏光下还观察到呈现马耳他十字图案的单个小球体。能量色散X射线光谱分析表明，融合沉积物的成分与羟基磷灰石相似。
仅在硅胶板襻设计的人工晶状体中报道了星状玻璃体病变与人工晶状体营养不良性钙化之间的关联。使三片式硅胶晶状体混浊的物质可能来源于星状体或导致这种玻璃体状况的过程。对其他患有星状玻璃体病变的人工晶状体眼患者进行临床评估，将确定这种现象是否仅限于硅胶人工晶状体。
