Fernández-Buenaga Roberto, Alió Jorge L
Vissum Corporation, Alicante, Spain.
Division of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain.
Asia Pac J Ophthalmol (Phila). 2017 Jul-Aug;6(4):372-380. doi: 10.22608/APO.2017181.
Intraocular lens (IOL) explantation after uneventful cataract surgery is rare but associated with a high risk of complications. In the past few years, the number of published reports about IOL explantation has grown significantly and most of them focus on explantation surgery due to spontaneous late IOL in-the-bag dislocations. This is related to the growth of the pseudophakic population, first as a result of longer lifespans, and second, because the improvements in safety and accuracy of phacoemulsification surgery have led to an increased number of phacorefractive procedures performed in younger patients. The improvement in phacoemulsification surgery goes in tandem with higher patient demands and expectations of the surgery. Therefore, incorrect lens power or patients who fail to neuroadapt to multifocal IOLs are also well‑recognized indications for IOL explantation and exchange. IOL opacification, although it was an epidemic in the past especially associated with certain IOL models, is currently still occurring even with some new IOL models. The outcomes of explantation surgeries are analyzed in this review separately according to the reason for explantation. Finally, the main reported IOL explantation techniques are reviewed as well.
在白内障手术顺利完成后进行人工晶状体(IOL)取出术的情况较为罕见,但并发症风险很高。在过去几年中,关于IOL取出术的已发表报告数量显著增加,其中大多数集中于因IOL自发晚期囊袋内脱位而进行的取出手术。这与人工晶状体植入人群的增长有关,一方面是由于寿命延长,另一方面是因为超声乳化手术安全性和准确性的提高导致年轻患者中进行的晶状体屈光手术数量增加。超声乳化手术的改进与患者对手术的更高要求和期望同步。因此,晶状体屈光度不正确或未能适应多焦点IOL的患者也是IOL取出和更换的公认指征。IOL混浊虽然过去曾是一种流行病,尤其与某些IOL型号相关,但目前即使是一些新型IOL也仍会出现这种情况。本综述根据取出原因分别分析了取出手术的结果。最后,还对主要报道的IOL取出技术进行了综述。