Haymore Jonathan, Zaidman Gerald, Werner Liliana, Mamalis Nick, Hamilton Stephan, Cook James, Gillette Thomas
John A. Moran Eye Center, University of Utah, Salt Lake City, Utah 84132, USA.
Ophthalmology. 2007 Sep;114(9):1689-95. doi: 10.1016/j.ophtha.2006.12.024.
To report 8 patients with misdiagnosis of MemoryLens intraocular lens (IOL) late postoperative calcification and the resulting potentially avoidable procedures leading to secondary complications.
Retrospective interventional case series.
Eight patients with an opacified hydrophilic acrylic MemoryLens.
Eight cases of MemoryLens IOL opacification that were originally misdiagnosed were reviewed. The following parameters were noted: baseline patient characteristics, time frame of IOL opacification, original misdiagnosis, subsequent surgical procedures, and postexplantation outcomes and complications. Two explanted lenses from this series were available for laboratory analyses. They underwent gross and light microscopic evaluation and scanning electron microscopy with energy-dispersive x-ray spectroscopy (EDS).
Patient parameters noted above. The IOLs were examined for distribution, structure, and composition of the deposits causing opacification of their optic components.
All 8 patients' IOLs were implanted between August 1999 and March 2000. Complaints of decreased visual function occurred 13 to 58 months after implantation. Half of the patients were initially diagnosed as having posterior capsular opacification and underwent neodymium:yttrium-aluminum-garnet laser capsulotomy. The other half were initially diagnosed with some form of vitreous involvement and underwent vitrectomies. Six of the 8 patients underwent subsequent lens exchanges, with 3 of them having postexchange complications including endophthalmitis, cystoid macular edema, and retinal detachment. Scanning electron microscopy with EDS confirmed the presence of calcified deposits on the surface of the 2 explants available for analysis. The deposits also stained positive for calcium.
Despite previous reports, misdiagnosis of MemoryLens IOL calcification leading to optic opacification still occurs. Not recognizing this process can lead to potentially avoidable surgical procedures and increased risk of complications after repeated interventions.
报告8例人工晶状体（IOL）MemoryLens术后晚期钙化误诊病例，以及由此导致的可能避免的手术及继发并发症。
回顾性干预病例系列。
8例亲水性丙烯酸MemoryLens混浊患者。
回顾8例最初被误诊的MemoryLens人工晶状体混浊病例。记录以下参数：患者基线特征、人工晶状体混浊的时间范围、最初的误诊、后续手术操作以及取出人工晶状体后的结果和并发症。该系列中有2枚取出的人工晶状体可用于实验室分析。对其进行大体和光学显微镜评估以及带能谱仪的扫描电子显微镜检查（EDS）。
上述患者参数。检查人工晶状体上导致其光学部件混浊的沉积物的分布、结构和成分。
所有8例患者的人工晶状体均于1999年8月至2000年3月植入。植入后13至58个月出现视功能下降的主诉。一半患者最初被诊断为后囊膜混浊并接受了钕：钇铝石榴石激光囊膜切开术。另一半最初被诊断为某种形式的玻璃体受累并接受了玻璃体切除术。8例患者中有6例随后进行了人工晶状体置换，其中3例在置换后出现并发症，包括眼内炎、黄斑囊样水肿和视网膜脱离。带能谱仪的扫描电子显微镜检查证实，可用于分析的2枚取出人工晶状体表面存在钙化沉积物。沉积物钙染色也呈阳性。
尽管有既往报道，但MemoryLens人工晶状体钙化导致光学部件混浊的误诊仍有发生。未认识到这一过程可能导致潜在可避免的手术操作，并增加重复干预后并发症的风险。
