Marques Frederico França, Marques Daniela Mieira Villano, Matsumoto Fabio Kenji
Department of Ophthalmology and Visual Sciences, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Arq Bras Oftalmol. 2017 Jun;80(3):199-201. doi: 10.5935/0004-2749.20170049.
We describe a unique complication during primary posterior continuous curvilinear capsulorhexis (PCCC) in a patient with megalocornea scheduled for phacoemulsification with toric multifocal intraocular lens (IOL) implantation. After nucleus emulsification and cortex removal, the capsular bag was filled with cohesive viscoelastic in preparation for PCCC to achieve reverse optic capture of the IOL, thus ensuring stability. However, as soon as the initial puncture was made using a 27-gauge needle to start the capsulotomy, the posterior capsule opening extended peripherally from 0º-180º. This capsule extension was similar to the Argentinean-flag sign in hypermature cataracts, and both are caused by excessive intracapsular pressure. Careful bimanual manipulation was performed to implant the IOL on the desired axis, which occurred uneventfully. At a postoperative visit, the patient exhibited excellent uncorrected visual acuity with a well-aligned IOL.
我们描述了一例患有大角膜的患者在计划行超声乳化联合植入散光多焦点人工晶状体（IOL）时，原发性后连续环形撕囊（PCCC）过程中出现的一种独特并发症。在核乳化和皮质清除后，囊袋内填充了粘性粘弹剂，为PCCC做准备，以实现IOL的反向光学捕获，从而确保稳定性。然而，一旦使用27号针头进行初始穿刺以开始撕囊，后囊开口就从0°向周边延伸至180°。这种囊袋延伸类似于过熟期白内障中的阿根廷国旗征，两者均由囊内压力过高引起。通过仔细的双手操作，将IOL植入到所需轴线上，过程顺利。在术后随访时，患者未矫正视力极佳，IOL位置良好。
