Altaie Rasha, Loane Edward, O'Sullivan Kathleen, Beatty Stephen
Department of Ophthalmology, Waterford Regional Hospital, Dunmore Road, Waterford, Ireland.
Br J Ophthalmol. 2007 Mar;91(3):299-302. doi: 10.1136/bjo.2006.095414. Epub 2006 Oct 31.
To report the clinical and surgical outcomes following exchange of opacified Hydroview intraocular lenses (IOLs), and to relate the final visual and anatomic results to clinical and surgical variables.
This is a prospective study of seventy-three eyes that underwent exchange of opacified Hydroview IOLs in Waterford Regional Hospital, Ireland. Preoperative, intraoperative and postoperative details were recorded.
This study comprised 73 eyes of 71 consecutive patients undergoing IOL exchange, performed at mean (+/-SD) intervals of 36.64 (+/-9.9) months following the primary cataract surgery. The mean (+/-SE) follow-up following the exchange procedure was 13 (+/-1) months (range: 1-45 months). The secondary IOL was placed in the capsular bag, in the sulcus, and in the anterior chamber in 22 (30.1%), 24 (32.9%) and 27 (37%) cases, respectively. The IOL exchange procedure was uneventful in 36 eyes (49.3%), whereas intraoperative events such as posterior capsule rupture, vitreous loss and zonular dehiscence were seen in the remainder (50.7%). Following the IOL exchange procedure, a significant improvement in best corrected visual acuity (BCVA) was noted at one and at three months, and at the final visit (Wilcoxon signed ranks test: p<0.001, p = 0.006, and p<0.001, respectively). Following exclusion of eyes with visually consequential ocular comorbidity, a better final BCVA was noted among those eyes where the secondary IOL was placed in the capsular bag or in the sulcus when compared with placement of the secondary IOL in the anterior chamber (IOL in the bag or sulcus: 26 eyes (35.6%), median (IQR) final BCVA: 0.2 (0.10-0.40); IOL in the anterior chamber: 19 eyes (26.02%), median (IQR) final BCVA: 0.5 (0.20-0.60); Mann Whitney U Test: p = 0.004).
IOL exchange is a technically challenging, but visually rewarding procedure. However, placement of the secondary IOL in the anterior chamber is associated with a poorer visual outcome when compared with placement of the secondary IOL in the sulcus or in the capsular bag.
报告混浊的Hydroview人工晶状体（IOL）置换后的临床和手术结果，并将最终的视力和解剖学结果与临床及手术变量相关联。
这是一项对爱尔兰沃特福德地区医院73只接受混浊Hydroview IOL置换术的眼睛进行的前瞻性研究。记录了术前、术中和术后的详细情况。
本研究包括71例连续患者的73只接受IOL置换的眼睛，在初次白内障手术后平均（±标准差）36.64（±9.9）个月进行置换。置换手术后的平均（±标准误）随访时间为13（±1）个月（范围：1 - 45个月）。二次IOL分别植入囊袋、睫状沟和前房的病例数为22例（30.1%）、24例（32.9%）和27例（37%）。36只眼睛（49.3%）的IOL置换手术顺利，其余眼睛（50.7%）出现了术中并发症，如后囊破裂、玻璃体丢失和悬韧带断裂。IOL置换手术后，1个月、3个月及末次随访时最佳矫正视力（BCVA）均有显著改善（Wilcoxon符号秩检验：p<0.001、p = 0.006和p<0.001）。排除有影响视力的眼部合并症的眼睛后，与二次IOL植入前房相比，二次IOL植入囊袋或睫状沟的眼睛最终BCVA更好（IOL植入囊袋或睫状沟：26只眼睛（35.6%），最终BCVA中位数（四分位间距）：0.2（0.10 - 0.40）；IOL植入前房：19只眼睛（26.02%），最终BCVA中位数（四分位间距）：0.5（0.20 - 0.60）；Mann Whitney U检验：p = 0.004）。
IOL置换是一项技术上具有挑战性但在视力改善方面有成效的手术。然而，与二次IOL植入睫状沟或囊袋相比，二次IOL植入前房的视力结果较差。
