Rau Ricardo, Santana Carmen Resende, Martinez Andrea Alejandra Gonzalez, Silva André Luiz de Freitas, Allemann Norma
Departamento de Oftalmologia, Universidade Federal de São Paulo - UNIFESP - São Paulo (SP), Brasil.
Arq Bras Oftalmol. 2013 May-Jun;76(3):147-51. doi: 10.1590/s0004-27492013000300003.
To evaluate the position of haptics of intraocular lens intentionally implanted in the ciliary sulcus in eyes undergoing cataract surgery complication associated with intraoperative posterior capsule rupture, as well as to correlate the findings with clinical changes observed in ophthalmic examination, utilizing ultrasound biomicroscopy.
Eleven eyes (11 patients) who had posterior capsule rupture during cataract surgery with intentional implantation of the haptics in the ciliary sulcus, underwent complete ophthalmic examination and ultrasound biomicroscopy. Ultrasound biomicroscopy evaluated the parameters: positioning of the distal portion of the haptics, tilt and decentration of the intraocular lens. Ophthalmic examination was aimed to evaluate the presence of flare and cells in the anterior chamber, deposits on the lens and iris transillumination defects. Intraocular pressure was measured, pigmentation of the trabecular meshwork was determined, and a fundoscopic evaluation was needed to rule out peripheral retinal rupture and macular edema.
Mean postoperative time for the examinations: 103.09 ± 32.93 days. Asymmetry of the haptics positioning was observed in 3 eyes (27.2%) that had one haptic in the ciliary sulcus, the second haptic was placed in the pars plana in 2 eyes, associated to intraocular lens tilt and decentration; or in the ciliary body (1 eye). Ophthalmic examination observed: 5 (45.5%) eyes with iris transillumination defects, 2 (18.1%) with intraocular lens decentration; 1 eye (9%) presented ocular hypertension. In all cases trabecular hyperpigmentation was observed at gonioscopy. No cases of peripheral retinal rupture and/or macular edema were reported.
Ultrasound biomicroscopy was able to locate the intraocular lens haptics intentionally implanted in the ciliary sulcus during complicated cataract surgery, and could demonstrate the relation of intraocular lens decentration to assymetric haptic implantation.
利用超声生物显微镜评估在白内障手术中因术中后囊破裂而将人工晶状体襻有意植入睫状沟的眼睛中人工晶状体襻的位置，并将这些发现与眼科检查中观察到的临床变化相关联。
11例（11只眼）在白内障手术中发生后囊破裂且人工晶状体襻有意植入睫状沟的患者，接受了全面的眼科检查和超声生物显微镜检查。超声生物显微镜评估了以下参数：襻远端的位置、人工晶状体的倾斜和偏心。眼科检查旨在评估前房内的闪光和细胞、晶状体上的沉积物以及虹膜透照缺损。测量眼压，确定小梁网色素沉着，并且需要进行眼底镜检查以排除周边视网膜破裂和黄斑水肿。
检查的平均术后时间为：103.09±32.93天。在3只眼（27.2%）中观察到襻位置不对称，其中1个襻位于睫状沟，2只眼中第二个襻位于睫状体平坦部，伴有人工晶状体倾斜和偏心；或在睫状体（1只眼）。眼科检查观察到：5只眼（45.5%）有虹膜透照缺损，2只眼（18.1%）有人工晶状体偏心；1只眼（9%）出现高眼压。在所有病例中，房角镜检查均观察到小梁色素沉着增加。未报告周边视网膜破裂和/或黄斑水肿的病例。
超声生物显微镜能够定位在复杂白内障手术期间有意植入睫状沟的人工晶状体襻，并能显示人工晶状体偏心与襻不对称植入的关系。
