Neumann A C, Cobb B
Neumann Eye Institute, DeLand, Florida 32720.
J Cataract Refract Surg. 1989 May;15(3):257-63. doi: 10.1016/s0886-3350(89)80082-3.
We report our clinical experience with six soft intraocular lenses: (1) STAAR silicone, (2) CooperVision/Schlegel silicone, (3) IOLAB silicone, (4) Allergan Medical Optics (AMO) silicone, (5) Fyodorov silicone, and (6) Alcon hydrogel (IOGEL). We found that these soft intraocular lenses have several common design problems. The single-size design of five of the six soft lenses can lead to a windshield-wiper decentration effect in lenses too small for larger eyes. We observed several instances in which the one-piece lenses became decentered, subluxed, and vaulted anteriorly against the iris or posteriorly away from the iris as postoperative capsulozonular changes occurred. We found that the insertion methods for these soft lenses need refining to reduce the risk of intraocular damage and wound stretching if the lenses are to be folded and inserted through a small 3.0 mm to 3.5 mm incision. The surface and physical characteristics of these lenses may also require further study. We observed folding grooves, sebacium deposits, and rust from the insertion instrument on some lenses inside the postoperative eye and pigment dispersion associated with hydrogel lenses. We conclude that small diameter polymethylmethacrylate implants are the best choice for small incision cataract surgery at this time.
（1）STAAR硅酮人工晶状体，（2）库博光学/施莱格尔硅酮人工晶状体，（3）IOLAB硅酮人工晶状体，（4）爱尔康医疗光学（AMO）硅酮人工晶状体，（5）费奥多罗夫硅酮人工晶状体，以及（6）爱尔康水凝胶人工晶状体（IOGEL）。我们发现这些软性人工晶状体存在几个常见的设计问题。六种软性晶状体中有五种采用单一尺寸设计，对于眼睛较大的患者，过小的晶状体可能会导致雨刮器式偏中心效应。我们观察到几例病例，随着术后囊袋 zonular 变化的发生，一体式晶状体出现偏中心、半脱位，并向前抵住虹膜或向后远离虹膜。我们发现，如果要将这些软性晶状体折叠并通过3.0毫米至3.5毫米的小切口插入，其插入方法需要改进，以降低眼内损伤和伤口拉伸的风险。这些晶状体的表面和物理特性也可能需要进一步研究。我们在术后眼内的一些晶状体上观察到折叠凹槽、皮脂沉积物、插入器械造成的锈迹，以及与水凝胶晶状体相关的色素分散现象。我们得出结论，小直径聚甲基丙烯酸甲酯植入物是目前小切口白内障手术的最佳选择。
