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对5例因眼球穿孔伤导致无晶状体和部分虹膜缺失的儿童植入Artisan虹膜重建人工晶状体。

Implantation of the Artisan iris reconstruction intraocular lens in 5 children with aphakia and partial aniridia caused by perforating ocular trauma.

作者信息

Sminia Marije L, Odenthal Monica Th P, Gortzak-Moorstein Nitza, Wenniger-Prick Liesbeth J J M, Völker-Dieben Hennie J

机构信息

Department of Ophthalmology, Academic Medical Centre, Amsterdam, the Netherlands.

出版信息

J AAPOS. 2008 Jun;12(3):268-72. doi: 10.1016/j.jaapos.2007.11.014. Epub 2008 Mar 10.

Abstract

PURPOSE

To describe the long-term clinical results of the implantation of the Artisan iris reconstruction IOL in 5 eyes of 5 children for aphakia and partial aniridia attributable to penetrating ocular trauma.

METHODS

The charts of 5 children were retrospectively reviewed. The nature and the extent of injury; age at IOL implantation; visual, refractive, and cosmetic outcome; endothelial cell density; and complications and subsequent surgical interventions were evaluated.

RESULTS

Mean follow-up period was 8.9 years (range, 4.9-12.4). Mean age at implantation of the Artisan iris reconstruction IOL was 9.5 years (range, 7.7-12.7). Visual acuity improved in 2 of 5 eyes, remained stable in 2 of 5 eyes, and decreased in 1 of 5 eyes. Complaints of photophobia were reduced, and a satisfactory cosmetic outcome was achieved in 3 of 5 patients. The mean spherical equivalent refraction error at last follow-up was -4.0 D. Mean endothelial cell loss when compared with the healthy fellow eye was 42%. Two cases were complicated by partial luxation of the IOL, one case by persistent anterior uveitis and secondary glaucoma. One eye developed a retinal detachment.

CONCLUSIONS

The Artisan iris reconstruction IOL is a treatment option for the treatment of aniridia and aphakia due to penetrating ocular trauma in children. We emphasize the high-risk characteristics of the eyes treated and the importance of careful patient selection in the outcome of the implantation of the Artisan iris reconstruction IOL.

摘要

目的

描述Artisan虹膜重建人工晶状体植入5例儿童5只眼中治疗因穿透性眼外伤所致无晶状体眼和部分无虹膜症的长期临床结果。

方法

回顾性分析5例儿童的病历。评估损伤的性质和程度、人工晶状体植入时的年龄、视力、屈光和美容效果、内皮细胞密度以及并发症和后续手术干预情况。

结果

平均随访期为8.9年(范围4.9 - 12.4年)。Artisan虹膜重建人工晶状体植入时的平均年龄为9.5岁(范围7.7 - 12.7岁)。5只眼中2只眼视力提高,2只眼视力稳定,1只眼视力下降。畏光症状减轻,5例患者中有3例获得了满意的美容效果。末次随访时平均等效球镜屈光不正为-4.0 D。与健侧眼相比,平均内皮细胞损失率为42%。2例发生人工晶状体部分脱位,1例发生持续性前葡萄膜炎和继发性青光眼。1只眼发生视网膜脱离。

结论

Artisan虹膜重建人工晶状体是治疗儿童穿透性眼外伤所致无虹膜症和无晶状体眼的一种治疗选择。我们强调所治疗眼的高风险特征以及在Artisan虹膜重建人工晶状体植入结果中仔细选择患者的重要性。

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