Huang Yu-sen, Xie Li-xin, Wu Xiao-ming, Han Dong-sheng
State Key Lab Cultivation Base, Shandong Provincial Key Lab of Ophthalmology, Shandong Eye Istitute, Qingdao 266071, China.
Zhonghua Yan Ke Za Zhi. 2006 May;42(5):391-5.
To evaluate the long-term outcome in eyes had flexible open-loop anterior chamber intraocular lens (ACIOL) implantation.
Cataract extraction with primary flexible open-loop ACIOL and anterior vitrectomy were performed in 34 eyes (group I), and secondary AC IOL implantation were performed in 49 eyes (group II). Visual acuity, intraocular pressure (IOP), corneal endothelial cell, anterior chamber angle and the presence of associated complication were examined in a mean follow up of 4.8 years (range 3 to 7 years).
The final best correct visual acuity was 0.5 or better in 65 eyes (78.3%). The IOP were (13.55 +/- 3.21) mm Hg preoperatively and (13.40 +/- 4.29) mm Hg (1 mm Hg = 0.133 kPa) at the last follow-up (t = 0.5427, P = 0.5888). In group I, the corneal endothelial cell density were (2497 +/- 629)/mm(2) preoperatively, while at the last follow-up it was (1995 +/- 648)/mm(2) and the rate of endothelial cell loss was (20.6 +/- 14.1)%; In group II, the corneal endothelial cell density before and after operation was (2459 +/- 681)/mm(2) and (2238 +/- 817)/mm(2) respectively. The rate endothelial cell loss was higher in group I compared with group II (P = 0.023). Postoperative complication include transient secondary glaucoma caused by block of pupil in 4 eyes and remain of viscoelastic substance in 3 eyes, hypotension in 5 eyes, persistent glaucoma in 2 eyes, hyphema in 2 eyes, IOLs slightly dislocation and shift in 3 eyes, pupil deformation in 1 eye, retina detachment in 2 eyes, and corneal decompensation in 2 eyes.
Flexible open-loop ACIOL is relatively safe and effective in selected cataract surgery. Postoperative complication could be reduced if operative indication and surgical technique were emphasized.
评估行可折叠开环前房型人工晶状体（ACIOL）植入术患眼的长期预后。
对34只眼（I组）行白内障摘除联合一期可折叠开环ACIOL植入及前部玻璃体切除术，对49只眼（II组）行二期前房型人工晶状体植入术。平均随访4.8年（范围3至7年），检查视力、眼压（IOP）、角膜内皮细胞、前房角及相关并发症情况。
65只眼（78.3%）最终最佳矫正视力达到0.5或更好。术前眼压为（13.55±3.21）mmHg，末次随访时为（13.40±4.29）mmHg（1mmHg = 0.133kPa）（t = 0.5427，P = 0.5888）。I组术前角膜内皮细胞密度为（2497±629）/mm²，末次随访时为（1995±648）/mm²，内皮细胞丢失率为（20.6±14.1）%；II组手术前后角膜内皮细胞密度分别为（2459±681）/mm²和（2238±817）/mm²。I组内皮细胞丢失率高于II组（P = 0.023）。术后并发症包括4只眼因瞳孔阻滞导致的短暂性继发性青光眼、3只眼残留粘弹剂、5只眼低眼压、2只眼持续性青光眼、2只眼前房积血、3只眼人工晶状体轻度脱位和移位、1只眼瞳孔变形、2只眼视网膜脱离以及2只眼角膜失代偿。
可折叠开环ACIOL在选择性白内障手术中相对安全有效。强调手术适应证和手术技巧可减少术后并发症。
