Pozdeyeva Nadezhda A, Pashtayev Nikolay P, Lukin Vladislav P, Batkov Yevgeniy N
Svyatoslav Fyodorov MNTK Eye Microsurgery, Cheboksary, Russia.
J Cataract Refract Surg. 2005 Sep;31(9):1750-9. doi: 10.1016/j.jcrs.2005.02.037.
To determine the efficacy and safety of surgical implantation of artificial iris-lens diaphragm in patients with anatomic or functional iris deficiencies, aphakia or cataract.
Svyatoslav Fyodorov MNTK Eye Microsurgery, Cheboksary, Russia.
Twenty eyes of 19 consecutive patients with combined iris and lens pathology of traumatic or congenital etiology were identified for an interventional noncomparative case series. The newly proposed model of an elastic iris-lens diaphragm with a colored haptic and additional support elements was implanted using various fixation approaches.
Fifteen eyes (75%) experienced improvement in corrected visual acuities. The best spectacle-corrected visual acuity (BSCVA) in 2 eyes did not change, while the uncorrected visual acuity (UCVA) in these eyes increased. There were 3 eyes in which BSCVA deteriorated with no change or even slight improvement in UCVA. All patients were satisfied with the cosmetic results of the surgery and reported a decrease in glare and photophobia. There was 1 intraoperative complication of vitreous hemorrhage. Postoperatively, 2 cases of hyphema, 1 case of ciliochoroidal detachment, 4 eyes with exaggerated immediate postoperative reaction, and 1 eye with persistent low-grade cyclitis were observed. In 1 eye, there was persistent intraocular pressure rise. One eye showed signs of cystoid macular edema. No iris-lens diaphragm decentrations and no new or extensions of old retinal detachments were seen during the follow-up period.
Artificial iris-lens diaphragm implantation effectively improved postoperative outcomes by correcting aphakia, reducing glare disability, and addressing cosmetic issues faced by iris-deficient, and aphakic or cataract patients. Although the iris-lens diaphragm appears to be safe, long-term results must be clarified in studies with longer follow-up and a larger patient population.
确定人工虹膜晶状体膈手术植入对有解剖学或功能性虹膜缺损、无晶状体眼或白内障患者的疗效和安全性。
俄罗斯切博克萨雷市斯维亚托斯拉夫·费奥多罗夫眼显微外科国家研究医疗中心。
对19例连续的因创伤或先天性病因导致虹膜和晶状体联合病变的患者的20只眼进行了一项介入性非对照病例系列研究。采用各种固定方法植入了新提出的带有彩色触觉和额外支撑元件的弹性虹膜晶状体膈模型。
15只眼（75%）矫正视力有所改善。2只眼的最佳眼镜矫正视力（BSCVA）未改变，但这些眼的未矫正视力（UCVA）有所提高。有3只眼的BSCVA恶化，而UCVA无变化甚至略有改善。所有患者对手术的美容效果都很满意，并报告眩光和畏光症状有所减轻。术中发生1例玻璃体出血并发症。术后观察到2例前房积血、1例睫状体脉络膜脱离、4只眼术后即刻反应过度以及1只眼持续性轻度睫状体炎。1只眼眼压持续升高。1只眼出现黄斑囊样水肿迹象。随访期间未见虹膜晶状体膈移位，也未见新的或旧的视网膜脱离扩展。
人工虹膜晶状体膈植入通过矫正无晶状体眼、减少眩光障碍以及解决虹膜缺损、无晶状体眼或白内障患者面临的美容问题，有效改善了术后效果。尽管虹膜晶状体膈似乎是安全的，但必须通过更长随访时间和更大患者群体的研究来明确长期结果。
