Kim Seung Mo, Choi Sangkyung
Department of Ophthalmology, Seoul Veterans Hospital, Seoul, Korea.
Korean J Ophthalmol. 2008 Dec;22(4):228-35. doi: 10.3341/kjo.2008.22.4.228.
To evaluate the clinical efficacy and complications of intraocular lens (IOL) exchange.
A review of medical records was performed for 52 eyes that had undergone an IOL exchange due to IOL opacification. Surgical complications and their incidences were analyzed. The mean best corrected visual acuity (BCVA) after the IOL exchange was compared with the mean pre-exchange BCVA and with the mean BCVA after the initial IOL implantation. Prediction error of refraction and biometric data obtained for the IOL exchange were, if available, compared with those obtained for the initial IOL implantation. The prediction error for the IOL exchange, calculated from the biometric data obtained before the IOL exchange, was compared with that calculated from the measurements obtained before the initial IOL implantation.
The overall complication rates were low and no serious complications were found. The mean BCVA improved significantly after the IOL exchange and was not significantly different from that obtained after the initial IOL implantation. However, the refractive prediction for the IOL exchange was not as good as it was for the initial IOL implantation, which was thought to be related with difficulties in axial length (AL) measurements. Biometric data taken before the initial IOL implantation was associated with a significantly better refractive prediction than those taken before the IOL exchange.
IOL exchange was both efficacious and safe for visual recovery. However, IOL exchange was related with increased difficulty of predicting postoperative refraction; difficulties in AL measurements are the suggested cause.
评估人工晶状体(IOL)置换术的临床疗效及并发症。
对52只因IOL混浊而接受IOL置换术的患眼的病历进行回顾。分析手术并发症及其发生率。将IOL置换术后的平均最佳矫正视力(BCVA)与置换术前的平均BCVA以及初次IOL植入后的平均BCVA进行比较。若有可用数据,将IOL置换术获得的屈光预测误差和生物测量数据与初次IOL植入时获得的数据进行比较。将根据IOL置换术前获得的生物测量数据计算出的IOL置换术预测误差与根据初次IOL植入术前测量值计算出的预测误差进行比较。
总体并发症发生率较低,未发现严重并发症。IOL置换术后平均BCVA显著改善,与初次IOL植入后获得的BCVA无显著差异。然而,IOL置换术的屈光预测不如初次IOL植入术,这被认为与眼轴长度(AL)测量困难有关。初次IOL植入术前获取的生物测量数据与屈光预测的相关性明显优于IOL置换术前获取的数据。
IOL置换术对视力恢复有效且安全。然而,IOL置换术与预测术后屈光的难度增加有关;AL测量困难是其原因。