Nikpoor Neda, Stone Donald U
Department of Ophthalmology, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma 73104, USA.
Ophthalmic Surg Lasers Imaging. 2010 Jul 29;41 Online. doi: 10.3928/15428877-20100726-12.
This case report retrospectively reviews the outcome of a 43-year-old man with retinitis pigmentosa who suffered rapid anterior capsular phimosis in each eye within 3 weeks following uncomplicated phacoemulsification with continuous curvilinear capsulorrhexis and single-piece acrylic intraocular lens (IOL) implantation. Anterior YAG capsulotomy was successfully performed in both eyes. It has been previously documented in the literature that capsular phimosis is more common in patients with retinitis pigmentosa. However, in the cases that were reviewed, capsular contracture progressed much less rapidly than in this patient. It is proposed that zonular dehiscence or increased lens epithelial cell fibrosis accompanying retinitis pigmentosa may be responsible for phimosis following phacoemulsification; in this case, the single-piece IOL may have offered less resistance to capsular contraction. Using a three-piece IOL, capsular tension ring, or making radial relaxing incisions in the anterior lens capsule may be useful approaches to minimize the aforementioned complications in patients with retinitis pigmentosa and cataracts.
本病例报告回顾性分析了一名43岁视网膜色素变性男性患者的情况，该患者在进行连续环形撕囊及单片式丙烯酸人工晶状体（IOL）植入的单纯白内障超声乳化术后3周内，双眼均迅速出现前囊膜闭锁。双眼均成功进行了YAG激光前囊膜切开术。此前文献记载，囊膜闭锁在视网膜色素变性患者中更为常见。然而，在所回顾的病例中，囊膜挛缩的进展比该患者要慢得多。据推测，视网膜色素变性伴随的悬韧带裂开或晶状体上皮细胞纤维化增加可能是超声乳化术后囊膜闭锁的原因；在本病例中，单片式IOL可能对囊膜收缩的抵抗力较小。使用三件式IOL、囊膜张力环或在前囊膜上做放射状松弛切口可能是将视网膜色素变性合并白内障患者上述并发症降至最低的有效方法。
