Fuchihata Mutsumi, Saito Yoshihiro, Kitaguchi Yoshiyuki, Nishida Kentaro, Hamanaka Noriko, Sakamoto Yoshihiro, Shiotani Yasuyuki, Nakae Kazuto, Kiuchi Yoshiaki, Tatebayashi Misako
Department of Ophthalmology, National Hospital Organization, Osaka National Hospital, Japan.
Nippon Ganka Gakkai Zasshi. 2006 Sep;110(9):736-40.
Calcification on the surface of the hydrogel intraocular lens (IOL) has been reported, but the mechanism of the surface calcification is not fully understood. We report a case of surface calcification on an implanted silicone IOL. The purpose of our study was to examine the clinical and ultrastructural findings associated with the late surface calcification of a silicone IOL.
A 70-year-old Japanese man had undergone cataract surgery in his left eye, with uneventful phacoemulsification and silicone IOL (Allergan SI-55 NB) implantation with the manufacturer's cartridge and injector. He was referred again 29 months later with blurred vision, glare sensitivity, and decreased vision in his left eye. He was diagnosed as having aftercataract. Although YAG laser capsulotomy was performed, the opacity on the posterior surface gradually increased. The opacity was located mainly within the capsulotomy window on the posterior surface of the lens, although the patient maintained good visual acuity. LV : 0.2 (1.0 x S-2.0 D). The lens was removed 46 months after the initial surgery. Scanning electron microscopy (SEM) showed membranous deposits on the posterior optical surface of the silicone lens. There were high levels of phosphoric acid (P) and calcium (C) confirming calcification of the silicone IOL. Asteroid hyalosis was observed in the fellow eye of the patient.
This is the first report of surface calcification of a silicone IOL in Japan. Although the mechanism of the calcification has not been determined, careful clinical follow-up of patients implanted with silicone lenses is necessary to determine if this phenomenon is rare and sporadic or if it may be more widespread. Since 5 similar cases of calcification in silicone lenses with accompanying asteroid hyalosis have been reported in other countries, we can conclude that silicone lens implantation in eyes with asteroid hyalosis should be avoided.
已有报道水凝胶人工晶状体（IOL）表面出现钙化，但表面钙化的机制尚未完全明确。我们报告了1例植入式硅凝胶IOL表面钙化的病例。本研究的目的是探讨与硅凝胶IOL晚期表面钙化相关的临床和超微结构表现。
一名70岁日本男性左眼接受了白内障手术，采用制造商的针筒和注射器顺利完成了超声乳化和硅凝胶IOL（爱尔康SI - 55 NB）植入。29个月后，他因左眼视力模糊、畏光和视力下降再次就诊。他被诊断为后发性白内障。尽管进行了YAG激光囊切开术，但晶状体后表面的混浊逐渐加重。混浊主要位于晶状体后表面的囊切开窗内，不过患者仍保持较好的视力。视力：0.2（1.0×S - 2.0 D）。初次手术后46个月取出晶状体。扫描电子显微镜（SEM）显示硅凝胶晶状体后光学表面有膜状沉积物。磷酸（P）和钙（C）含量较高，证实了硅凝胶IOL发生了钙化。在该患者的对侧眼中观察到了星状玻璃体变性。
这是日本首例关于硅凝胶IOL表面钙化的报道。尽管钙化机制尚未确定，但对于植入硅凝胶晶状体的患者进行仔细的临床随访是必要的，以确定这种现象是罕见且偶发的，还是可能更为普遍。由于其他国家已报道了5例类似的硅凝胶晶状体钙化病例并伴有星状玻璃体变性，我们可以得出结论，应避免在患有星状玻璃体变性的眼中植入硅凝胶晶状体。
