Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India.
Cont Lens Anterior Eye. 2012 Oct;35(5):230-2. doi: 10.1016/j.clae.2012.06.003. Epub 2012 Jul 24.
A child with microspherophakia is described who was managed with scleral fixation of the loose capsular bag using Ahmed capsular tension segment and the small capsular bag was expanded using a standard capsular tension ring.
The child presented initially with lenticular myopia and concomitant glaucoma for which he was treated with peripheral iridotomy alone. The IOP remained uncontrolled after iridotomy procedure. Therefore, bimanual clear lens aspiration was performed; standard capsular tension ring was implanted 'in the bag' and Ahmed capsular tension segment was sutured to the sclera to stabilize the capsular complex. Foldable acrylic IOL was then injected into the bag.
Postoperatively, the child had an unaided acuity of 20/30 on ETDRS. The IOL was centered well and the capsular bag had expanded due to the effect of CTR.
This 'dual support' technique takes advantage of using both CTR and CTS to overcome the generalized zonulopathy found in cases of microspherophakia. It effectively counteracts lenticular myopia, treats glaucoma, strengthens the capsular bag and does not entail the future risk of IOL-bag dislocation.
描述了一例患有小眼球的患儿，采用 Ahmed 囊袋张力环对松解的囊袋进行巩膜固定，并用标准的囊袋张力环扩大小囊袋。
患儿最初表现为晶状体性近视和伴发性青光眼，仅行周边虹膜切开术治疗。虹膜切开术后眼压仍不受控制。因此，行双手晶状体抽吸术；将标准的囊袋张力环植入“囊袋内”，并将 Ahmed 囊袋张力环缝合固定于巩膜以稳定囊袋复合体。然后将折叠式丙烯酸人工晶状体注入囊袋内。
术后患儿的最佳矫正视力为 ETDRS 的 20/30。人工晶状体居中良好，由于 CTR 的作用，囊袋扩张。
这种“双重支撑”技术利用 CTR 和 CTS 的优势，克服了小眼球症中普遍存在的广义悬韧带病。它有效地对抗晶状体性近视，治疗青光眼，加强囊袋，且不会带来人工晶状体-囊袋脱位的未来风险。
