Advanced Vision Care and the David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.
J Cataract Refract Surg. 2011 Jul;37(7):1199-207. doi: 10.1016/j.jcrs.2011.02.022.
To evaluate the benefit of various surgical methods to address pseudophakic negative dysphotopsia.
Private practice, Los Angeles, California, USA.
Interventional case series.
The following 4 surgical methods were used to treat negative dysphotopsia: secondary piggyback intraocular lens (IOL) implantation, reverse optic capture, in-the-bag IOL exchange, and iris suture fixation. Ultrasound biomicroscopy (UBM) was used to analyze posterior chamber anatomy. The primary outcome was partial or complete resolution of the negative dysphotopsia symptoms 3 months postoperatively.
Twelve eyes of 11 patients with negative dysphotopsia had surgical treatment. All 10 patients who had piggyback IOL implantation or reverse optic capture had partial or complete resolution of symptoms by 3 months. No patient who had in-the-bag IOL exchange (n = 3) or iris suture fixation of the capsular bag-IOL complex (n = 1) improved despite alteration of IOL material or edge design in the case of IOL exchange or UBM confirmation of posterior chamber collapse in the case of iris suture fixation of the capsular bag-IOL complex.
Consistent with a new hypothesis, resolution of negative dysphotopsia symptoms depended on IOL coverage of the anterior capsule edge rather than on collapse of the posterior chamber alone. Furthermore, negative dysphotopsia was not attributed to a particular IOL material or edge design. .
评估各种手术方法治疗后发性负性像差的益处。
美国加利福尼亚州洛杉矶的私人诊所。
介入性病例系列研究。
使用以下 4 种手术方法治疗负性像差：二次植入式眼内透镜（IOL）、反向光学捕获、囊袋内 IOL 置换和虹膜缝线固定。超声生物显微镜（UBM）用于分析后房解剖结构。主要结果是术后 3 个月时负性像差症状部分或完全缓解。
11 例负性像差患者的 12 只眼接受了手术治疗。行二次 IOL 植入或反向光学捕获的 10 例患者中，有 9 例症状部分或完全缓解。行囊袋内 IOL 置换的 3 例（n=3）和行囊袋-IOL 复合体虹膜缝线固定的 1 例（n=1）患者的症状均无改善，尽管 IOL 置换改变了 IOL 材料或边缘设计，或虹膜缝线固定证实了后房塌陷。
与新假说一致，负性像差症状的缓解取决于 IOL 对前囊边缘的覆盖，而不仅仅是后房的塌陷。此外，负性像差并非归因于特定的 IOL 材料或边缘设计。
