通过环境扫描电子显微镜分析内皮角膜移植术后人工晶状体混浊情况

Intraocular Lens Opacification After Endothelial Keratoplasty as Analyzed by Environmental Scanning Electron Microscopy.

作者信息

Verdaguer Paula, Gris Oscar, Casaroli-Marano Ricardo P, Elies Daniel, Muñoz-Gutierrez Gerardo, Güell Jose L

机构信息

*Department of Cornea and Refractive Surgery, Instituto de Microcirugía Ocular (IMO), Barcelona, Spain; †Universitat Autònoma de Barcelona, Barcelona, Spain; and ‡Department of Surgery, School of Medicine & Hospital Clínic de Barcelona (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.

出版信息

Cornea. 2015 Aug;34(8):972-5. doi: 10.1097/ICO.0000000000000468.

DOI:10.1097/ICO.0000000000000468

PMID:25970432

Abstract

PURPOSE

To describe a case of hydrophilic intraocular lens (IOL) opacification based on IOL analysis after Descemet stripping automated endothelial keratoplasty.

METHODS

A 60-year-old woman had uneventful phacoemulsification after the implantation of a hydrophilic IOL (Akreos-Adapt; Bausch & Lomb) into both eyes. Because of postoperative corneal decompensation in the right eye, 2 Descemet stripping automated endothelial keratoplasty operations were performed within 1 year. After the second procedure, the graft was not well attached, requiring an intracameral injection of air on day 3. After 1 year, opacification was observed on the superior 2/3 of the anterior surface of the IOL, along with a significant decrease in visual acuity. The IOL was explanted 6 months after the opacification.

RESULTS

Environmental scanning electron microscopy followed by x-ray microanalysis revealed an organic biofilm on the surface of the IOL.

CONCLUSIONS

To our knowledge, this is the first reported case in which the material deposited on the lens is organic rather than calcific.

摘要

目的

描述1例在Descemet膜剥除自动内皮角膜移植术后基于人工晶状体（IOL）分析的亲水性人工晶状体混浊病例。

方法

一名60岁女性双眼植入亲水性人工晶状体（Akreos-Adapt；博士伦公司）后顺利完成超声乳化手术。由于右眼术后角膜失代偿，在1年内进行了2次Descemet膜剥除自动内皮角膜移植手术。第二次手术后，植片附着不佳，术后第3天需要前房内注入空气。1年后，观察到人工晶状体前表面上2/3出现混浊，同时视力显著下降。混浊出现6个月后取出人工晶状体。