Park In Ki, Lee Je Myung, Chun Yeoun Sook
Department of Ophthalmology, College of Medicine, Kyung Hee University, Seoul, Korea.
Korean J Ophthalmol. 2008 Jun;22(2):130-2. doi: 10.3341/kjo.2008.22.2.130.
We report a case of recurrent occlusion of laser iridotomy (LI) sites after a Visian ICL (Implantable contact lens version 4, Staar Surgical AG, Nidau, Switzerland) implantation. A 45-year-old woman had bilateral ICL implantation after placement of two peripheral LI sites in each eye to prevent pupillary block. At one month after the operation, severe narrowing or occlusion of four LI sites occurred. After this, although she received four additional LIs at postoperative months 1, 6, 9 and 10 in both eyes, the narrowing or occlusion recurred. Mild chronic anterior chamber inflammation was observed intermittently throughout the follow-up period. We performed clear lens extraction in both eyes (at postoperative month 11 in the left eye and month 26 in the right eye) due to recurrent occlusion of the LI sites and excess trabecular meshwork pigment deposition presumably caused by the four repeated LIs. Recurrent obstruction of LI sites can occur after ICL implantation. These problems were unresolvable despite four repeated laser iridotomies. The risks associated with anterior uveitis must be considered when planning an ICL implantation.
我们报告了一例在植入Visian ICL（可植入式隐形眼镜4代，瑞士斯塔阿外科公司，尼道）后激光虹膜切开术（LI）部位反复闭塞的病例。一名45岁女性在每只眼睛植入两个周边LI部位以预防瞳孔阻滞之后进行了双侧ICL植入。术后1个月，四个LI部位出现严重狭窄或闭塞。此后，尽管她在术后第1、6、9和10个月双眼又接受了四次LI治疗，但狭窄或闭塞仍复发。在整个随访期间间歇性观察到轻度慢性前房炎症。由于LI部位反复闭塞以及推测由四次重复LI导致的小梁网色素沉着过多，我们对双眼进行了透明晶状体摘除术（左眼在术后第11个月，右眼在术后第26个月）。ICL植入后可能发生LI部位反复阻塞。尽管进行了四次重复激光虹膜切开术，这些问题仍无法解决。在计划ICL植入时必须考虑与前葡萄膜炎相关的风险。
