Galor Anat, Gonzalez Maricely, Goldman David, O'Brien Terrence P
Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Palm Beach Gardens, Florida 33418, USA.
J Cataract Refract Surg. 2009 Oct;35(10):1706-10. doi: 10.1016/j.jcrs.2009.05.022.
To evaluate surgical outcomes after intraocular lens (IOL) exchange of refractive IOLs in dissatisfied patients.
Bascom Palmer Eye Institute, Palm Beach Gardens, Florida, USA.
This retrospective case series comprised dissatisfied patients who sought consultation and subsequently had IOL exchange surgery to remove a refractive IOL. Data collected included preoperative subjective and objective findings, surgical technique, and postoperative course.
Ten patients (12 eyes) had IOL exchange. All patients had subjective visual symptoms before IOL exchange surgery. Despite this, the preoperative corrected distance visual acuity (CDVA) was 20/30 or better in all eyes. During IOL exchange surgery, a monofocal IOL was placed in the capsular bag or the ciliary sulcus. Adjunctive anterior vitrectomy was performed as indicated for vitreous prolapse. The median follow-up after IOL exchange surgery was 8.9 months. Eight patients (10 eyes) were satisfied with the results of the IOL exchange surgery, while 2 patients said their initial symptoms persisted after the exchange. The CDVA was 20/25 or better in 9 eyes at 1 month. The CDVA in the remaining 3 eyes improved to 20/25 or better at 3 months (2 patients) or 6 months (1 patient). One patient had a complicated postoperative course that necessitated repeat IOL exchange with scleral fixation due to inadequate capsule support. Another patient had corneal decompensation after the IOL exchange surgery.
Results show that IOL exchange is a feasible option for dissatisfied patients with persistent visual symptoms after refractive IOL placement.
评估对屈光性人工晶状体植入术后不满意患者进行人工晶状体（IOL）置换的手术效果。
美国佛罗里达州棕榈滩花园市巴斯科姆·帕尔默眼科研究所。
本回顾性病例系列研究纳入了对手术效果不满意并前来咨询，随后接受IOL置换手术以取出屈光性IOL的患者。收集的数据包括术前主观和客观检查结果、手术技术及术后病程。
10例患者（12只眼）接受了IOL置换。所有患者在IOL置换手术前均有主观视觉症状。尽管如此，所有患眼术前矫正远视力（CDVA）均为20/30或更好。在IOL置换手术过程中，将单焦点IOL植入囊袋或睫状沟。根据玻璃体脱出情况进行辅助性前部玻璃体切除术。IOL置换手术后的中位随访时间为8.9个月。8例患者（10只眼）对IOL置换手术的结果满意，而2例患者表示置换后最初的症状仍然存在。1个月时，9只眼的CDVA为20/25或更好。其余3只眼中，2只眼在3个月时、1只眼在6个月时CDVA提高到20/25或更好。1例患者术后病程复杂，由于囊袋支撑不足，需要通过巩膜固定进行再次IOL置换。另1例患者在IOL置换手术后出现角膜失代偿。
结果表明，对于屈光性IOL植入后有持续视觉症状的不满意患者，IOL置换是一种可行的选择。
