Zeng Qing-Yan, Xie Xiu-Li, Chen Qian
From the Aier School of Ophthalmology (Zeng), Central South University (Zeng), Changsha, and Wuhan Aier Eye Hospital (Zeng, Xie, Chen), Wuhan, China.
From the Aier School of Ophthalmology (Zeng), Central South University (Zeng), Changsha, and Wuhan Aier Eye Hospital (Zeng, Xie, Chen), Wuhan, China.
J Cataract Refract Surg. 2015 Mar;41(3):576-84. doi: 10.1016/j.jcrs.2014.06.036.
To analyze causes leading to explantation and exchange of Implantable Collamer Lens phakic intraocular lenses (pIOLs) and examine the surgical techniques of pIOL exchange.
Wuhan Aier Eye Hospital, Wuhan, China.
Retrospective analysis of prospectively collected data.
Different techniques were used to explant the pIOLs based on the amount of vaulting. Preoperative and postoperative data were collected to evaluate possible causes leading to pIOL exchange and the safety of pIOL exchange.
Of 616 myopic eyes with previous pIOL implantation, 16 eyes of 15 patients having pIOL exchange were reviewed. Eight surgeries (50%) were performed because of low vaulting (≤100 μm) and another 8 (50%) because of too high vaulting (≥1000 μm). The causes leading to low vaulting included increased crystalline lens thickness (≥4.0 mm), low anterior chamber depth (ACD) (<3.1 mm), and a too-small pIOL (<12.0 mm). The high vaulting was primarily the result of oversized white-to-white (WTW) measurements with Scheimpflug pachymetry (Pentacam) or the use of a digital caliper by an unskilled examiner and of ciliary body cysts. Six months after pIOL exchange, the vaulting ranged from 162 to 715 μm. No anterior subcapsular cataracts or other complications occurred during the observation period.
The main causes of abnormal vaulting and subsequent pIOL exchange included a thick crystalline lens, low ACD, too-small pIOL, WTW measurement error, and ciliary body cysts. Phakic IOL explantations were individually designed based on the vaulting to achieve proper safety and efficacy.
No author has a financial or proprietary interest in any material or method mentioned.
分析可植入式胶原晶状体有晶状体眼人工晶状体（pIOL）取出及置换的原因，并探讨pIOL置换的手术技巧。
中国武汉爱尔眼科医院。
对前瞻性收集的数据进行回顾性分析。
根据房拱高度采用不同技术取出pIOL。收集术前和术后数据，以评估导致pIOL置换的可能原因及pIOL置换的安全性。
在616只曾植入pIOL的近视眼中，对15例患者的16只眼进行了pIOL置换回顾。8例手术（50%）因房拱过低（≤100μm）进行，另外8例（50%）因房拱过高（≥1000μm）进行。导致房拱过低的原因包括晶状体厚度增加（≥4.0mm）、前房深度降低（ACD）（<3.1mm）以及pIOL过小（<12.0mm）。房拱过高主要是由于使用眼前节分析系统（Pentacam）进行的白到白（WTW）测量过大，或非熟练检查者使用数字卡尺测量以及睫状体囊肿所致。pIOL置换6个月后，房拱高度在162至715μm之间。观察期内未发生前囊下白内障或其他并发症。
房拱异常及随后pIOL置换的主要原因包括晶状体增厚、ACD降低、pIOL过小、WTW测量误差以及睫状体囊肿。根据房拱高度对有晶状体眼人工晶状体取出术进行个体化设计，以实现适当的安全性和有效性。
没有作者对文中提及的任何材料或方法拥有财务或专利权益。
