Sayman Muslubas Isil Bahar, Kandemir Baran, Aydin Oral Ayse Yesim, Kugu Suleyman, Dastan Metin
Eye Clinic, Hakkari Government Hospital, Hakkari 30000, Turkey.
Eye Clinic, Dr. Lütfi Kirdar Kartal Education and Training Hospital, Istanbul 34864, Turkey.
Int J Ophthalmol. 2014 Apr 18;7(2):376-80. doi: 10.3980/j.issn.2222-3959.2014.02.32. eCollection 2014.
To report the long-term vision-threatening complications in patients who underwent phakic intraocular lens (pIOLs) implantation for high myopia.
This study was designed from a consecutive series of phakic intraocular lens complication and corrective surgeries. Sixteen eyes of 13 patients had implantation of phakic intraocular lens for correction high myopia and developed serious complications have been included in this study. The mean age of patients was 38.6±6.35y (range 32-50y) and the mean time of history of pIOL implantation for high myopia was 6±2y (range 2-10y). Before corrective surgery, best spectacle-corrective visual acuity (BSCVA) ranged from perception to 20/200 in the eyes in which severe complications occurred.
Corneal decompensation occurred in 12 eyes of 9 high myopic patients after anterior chamber pIOL implantation. Rhegmatogenous retinal detachment (RRD) occurred in 4 eyes of 4 high myopic patients following anterior chamber and posterior chamber pIOL implantation. Patients with corneal decompensation, had combined procedures consisting of pIOL removal and penetrating keratoplasty (PKP). Removals of pIOL, phacoemulsification and pars plana vitrectomy (PPV) with silicone oil tamponade were performed in patients with RRD. After corrective surgeries, all patients but one (P+, patient 2, right eye) achieved moderate BSCVA ranged from 20/200 to 20/50 at the last visit.
Phakic IOLs may be effective for the correction of high myopia. Although these IOLs may have severe complications and it affects safety and efficacy of this surgery. As seen here, corneal decompensation and rhegmatogenous retinal detachment are possible postoperative vision-threatening complications of phakic IOLs. Patients must be carefully examined before and after surgery for possible endothelial cell loss and vitreoretinal problems.
报告接受有晶体眼人工晶状体（pIOL）植入术治疗高度近视患者的长期视力威胁性并发症。
本研究源自一系列连续性的有晶体眼人工晶状体并发症及矫正手术。13例患者的16只眼接受了有晶体眼人工晶状体植入术以矫正高度近视并出现了严重并发症，纳入本研究。患者平均年龄为38.6±6.35岁（范围32 - 50岁），有晶体眼人工晶状体植入治疗高度近视的平均时间为6±2年（范围2 - 10年）。在矫正手术前，发生严重并发症的眼中最佳矫正视力（BSCVA）范围从光感到20/200。
9例高度近视患者在前房有晶体眼人工晶状体植入术后12只眼发生角膜失代偿。4例高度近视患者在前房和后房有晶体眼人工晶状体植入术后4只眼发生孔源性视网膜脱离（RRD）。发生角膜失代偿的患者接受了包括取出有晶体眼人工晶状体和穿透性角膜移植术（PKP）的联合手术。发生RRD的患者接受了取出有晶体眼人工晶状体、超声乳化白内障吸除术和平坦部玻璃体切除术（PPV）并硅油填充。矫正手术后，除1例患者（P +，患者2，右眼）外，所有患者在最后一次随访时达到了20/200至20/50的中度BSCVA。
有晶体眼人工晶状体可能对矫正高度近视有效。尽管这些人工晶状体可能有严重并发症，且影响该手术的安全性和有效性。如此处所见，角膜失代偿和孔源性视网膜脱离是有晶体眼人工晶状体术后可能威胁视力的并发症。手术前后必须仔细检查患者是否可能存在内皮细胞丢失和玻璃体视网膜问题。
