Sanders Donald R, Higginbotham Robert W, Opatowsky Ira E, Confino Joel
Center for Clinical Research, Elmhurst, Illinois, USA.
J Cataract Refract Surg. 2006 Dec;32(12):2110-2. doi: 10.1016/j.jcrs.2006.07.030.
To describe reports of refractive hyperopic shift over time following intraocular lens (IOL) implantation, discuss possible etiologies, and suggest preventive and therapeutic treatments.
Multiple U.S. ophthalmic surgical centers; data collection at Staar Surgical, Monrovia, California, USA.
Forty cases displaying a progressive hyperopic shift in refraction after implantation of the single-piece Collamer IOL (Staar Surgical) were reported to the manufacturer out of 160 000 that have been implanted since its commercial introduction in April 2000. A retrospective data analysis of these 40 cases was performed; parameters included the mean refractive change over time, presence of capsular fibrosis, IOL displacement, and outcomes of secondary treatments. Individual case examples are presented.
The mean refractive shift was 1.81 diopters (D) (range 0.25 to 3.75 D) with 5 cases (14%) demonstrating a hyperopic shift greater than 3.0 D. In 38 of the 40 cases, some combination of the following were reported: posterior displacement of the IOL, capsule fibrosis, and/or relief of the condition by performance of a radial or circumferential anterior neodymium:YAG capsulotomy to relieve capsule tension. The use of a small (less than 5.5 mm) capsulorhexis was also associated with cases showing the hyperopic shift.
The most likely etiology was the development of anterior capsule fibrosis, sometimes exacerbated by a small capsulorhexis, which could cause the IOL to move posteriorly, resulting in a hyperopic change in refraction. Previous in vitro testing by the manufacturer ruled out a change in the refractive power of the IOL in the eye as a cause of this phenomenon.
描述人工晶状体（IOL）植入术后随时间推移出现的屈光性远视漂移的报告，讨论可能的病因，并提出预防和治疗方法。
多个美国眼科手术中心；在美国加利福尼亚州蒙罗维亚的STAAR Surgical公司进行数据收集。
自2000年4月单片式Collamer人工晶状体（STAAR Surgical公司）商业化推出以来，在已植入的160000例中，有40例报告出现了植入后屈光逐渐向远视漂移的情况，并上报给了制造商。对这40例病例进行了回顾性数据分析；参数包括随时间的平均屈光变化、囊膜纤维化的存在、人工晶状体移位以及二次治疗的结果。并给出了个别病例示例。
平均屈光漂移为1.81屈光度（D）（范围为0.25至3.75 D），5例（14%）表现出大于3.0 D的远视漂移。在40例中的38例中，报告了以下情况的某种组合：人工晶状体向后移位、囊膜纤维化和/或通过进行放射状或环形前部钕：钇铝石榴石囊膜切开术缓解囊膜张力来改善病情。使用小（小于5.5 mm）的连续环形撕囊也与出现远视漂移的病例有关。
最可能的病因是前囊膜纤维化的发展，有时小的连续环形撕囊会使其加剧，这可能导致人工晶状体向后移动，从而引起屈光的远视变化。制造商之前的体外测试排除了眼内人工晶状体屈光力变化是这种现象的原因。
