Gupta Isha, Oakey Zack, Stagg Brian C, Ambati Balamurali K
University of Utah School of Medicine, Salt Lake City, Utah, USA.
Case Rep Ophthalmol. 2013 Jun 28;4(2):57-60. doi: 10.1159/000353497. Print 2013 May.
We report the case of a 40-year-old female patient treated with implantation of the Acrysof® IQ ReSTOR® lens (Alcon, Fort Worth, Tex., USA) with overlaying Acrysof EXpand® minus piggyback lens (Alcon).
The patient had high myopia and was diagnosed with presbyopia and bilateral posterior subcapsular cataract. She desired to be spectacle-free and opted to undergo bilateral placement of the ReSTOR multifocal lens. The necessary intraocular lens (IOL) power was +3.5 in the right eye and +4.0 in the left eye, though the range of commercially available ReSTOR lenses is +6.0 to +34.0 D. In order to achieve emmetropia in this case of high myopia, it was determined that an EXpand minus piggyback lens would be necessary.
Implantation of the ReSTOR lens with overlaying EXpand minus piggyback lens was performed successfully and without complication. At 5 months postoperatively, the patient had 20/20 uncorrected visual acuity in both eyes. She reported a high level of satisfaction and was able to return to her daily activities including reading and driving without spectacles.
We report successful primary implantation of AcrySof EXpand minus piggyback lenses overlying the AcrySof IQ ReSTOR lens in a patient with high myopia. Long-term follow-up and further evaluation is necessary to establish piggyback IOL implantation with multifocal IOL as an accepted treatment for high myopia with presbyopia.
我们报告了一例40岁女性患者的病例，该患者接受了爱尔康公司（美国得克萨斯州沃思堡）的Acrysof® IQ ReSTOR® 人工晶状体植入术，并叠加了Acrysof EXpand® 负度数附加晶状体（爱尔康）。
该患者患有高度近视，被诊断为老花眼和双侧后囊下白内障。她希望摆脱眼镜，选择接受双侧ReSTOR多焦点人工晶状体植入。尽管市面上ReSTOR人工晶状体的屈光度范围为+6.0至+34.0 D，但该患者右眼所需的人工晶状体屈光度为+3.5，左眼为+4.0。为了在这种高度近视情况下实现正视，确定需要植入一枚EXpand负度数附加晶状体。
成功植入了ReSTOR人工晶状体并叠加EXpand负度数附加晶状体，且无并发症。术后5个月，患者双眼未矫正视力均达到20/20。她表示满意度很高，能够恢复包括阅读和开车在内的日常活动，无需佩戴眼镜。
我们报告了在一名高度近视患者中成功将AcrySof EXpand负度数附加晶状体叠加在AcrySof IQ ReSTOR人工晶状体上进行一期植入。需要进行长期随访和进一步评估，以确立将附加人工晶状体与多焦点人工晶状体联合植入作为治疗伴有老花眼的高度近视的一种可接受的治疗方法。
