Bleckmann H, Hanuschik W
Augenabteilung der Schlosspark-Klinik, Berlin.
Klin Monbl Augenheilkd. 1991 Jan;198(1):9-14. doi: 10.1055/s-2008-1045920.
In a prospective study 28 patients were unilaterally implanted with a flexible posterior chamber lens made of poly-HEMA. Clinical results of 18 months follow up is reported. Implantation of the one-piece lens was more difficult in some patients according to the elastic property of the lens in comparison to PMMA-lenses. This is expressed in 8 patients in which a asymmetric sulcus-bag fixation of the lens was found. Postoperative visual acuity of better than 20/40 was found in 21 patients, which is rather the same as with hard intraocular implants. According to a lower refraction index of poly-HEMA the refractive power had to be chosen about 1 dpt higher than in PMMA-lenses. Early observation of the soft intraocular implants revealed 3 decentered lenses, in later follow up 5 implants were in an excentric position. One lens removal was performed due to diplopia. 16 of 28 patients revealed capsular fibrosis after 18 months follow up, in 8 patients a YAG-capsulotomy was performed. As an advantage of soft intraocular implants of poly-HEMA a good biocompatibility can be ruled out which is demonstrated in poor cell deposits on the lens surface and no synechias. The minor tendency to adheresis seems to favour on the other hand a destable fixation of the lens, which is expressed in the number of decentered lenses, possibly also in the observed capsular fibrosis.
在一项前瞻性研究中，28例患者单侧植入了由聚甲基丙烯酸羟乙酯（poly-HEMA）制成的软性后房型人工晶状体。报告了18个月随访的临床结果。与聚甲基丙烯酸甲酯（PMMA）人工晶状体相比，由于该人工晶状体的弹性特性，一体式人工晶状体的植入在一些患者中更困难。这在8例患者中表现为人工晶状体出现不对称的沟袋固定。21例患者术后视力优于20/40，这与硬性眼内植入物的情况相当。由于聚甲基丙烯酸羟乙酯的折射率较低，屈光力必须比聚甲基丙烯酸甲酯人工晶状体选择高约1屈光度。对软性眼内植入物的早期观察发现3例人工晶状体偏心，在后期随访中有5例植入物处于偏心位置。因复视而进行了1次人工晶状体取出术。28例患者中有16例在18个月随访后出现囊膜纤维化，8例患者进行了YAG激光晶状体后囊切开术。作为聚甲基丙烯酸羟乙酯软性眼内植入物的一个优点，可以确定其具有良好的生物相容性，这在晶状体表面细胞沉积少和无粘连方面得到体现。另一方面，较小的粘连倾向似乎有利于人工晶状体的不稳定固定，这在偏心人工晶状体的数量上有所体现，可能也体现在观察到的囊膜纤维化中。
