Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA.
Cançado-Trindade Eye Institute, Belo Horizonte, Brazil.
Eye (Lond). 2018 Mar;32(3):637-645. doi: 10.1038/eye.2017.239. Epub 2017 Oct 27.
PurposeTo evaluate a novel small-aperture supplementary implant that applies the principle of pinholes for management of irregular astigmatism, in postmortem human eyes.MethodsPseudophakic human cadaver eyes were imaged by anterior segment optical coherence tomography (AS-OCT) to assess position of the in-the-bag intraocular lens (IOL). Eyes were prepared as per the Miyake-Apple technique. Two versions of the supplementary implant (open-loop and tripod designs) were then inserted into the sulcus of each eye. Evaluations under AS-OCT and from anterior and posterior views of the anterior segment were used to assess IOL fixation, centration, tilt, and interlenticular distance (ILD). This experimental study has been conducted in John A. Moran Eye Center, University of Utah.ResultsNine eyes were selected, with various sizes, primary IOL materials/designs, and Soemmering's ring formation. The open-loop model exhibited a mild degree of decentration and tilt in 2 eyes with zonular dehiscence. Mild decentration and tilt of the tripod were observed in 4 eyes; in 1 additional eye it was centered but mildly tilted. Three eyes with zonular dehiscence had one of the closed loops of the tripod located posteriorly to the ciliary processes. In all cases, an ILD was observed between the lenses (open loop: 0.65±0.13 mm; tripod: 0.41±0.12 mm).ConclusionsIt is important to take into account anatomical aspects related to ciliary sulcus fixation of supplementary IOLs. Both designs evaluated, exhibited appropriate centration and ILD. The open-loop design had less risk of tilt in association with haptics protruding posteriorly through areas of zonular weakness.
目的
评估一种新型小切口补充植入物，该植入物应用针孔原理管理不规则散光，用于死后人类眼球。
方法
通过眼前节光学相干断层扫描（AS-OCT）对后房型人工晶状体（IOL）位置进行成像。按照 Miyake-Apple 技术准备眼球。然后将两种设计的补充植入物（开环和三脚架设计）插入每个眼睛的巩膜沟。通过 AS-OCT 和眼前节的前后视图进行评估，以评估 IOL 固定、居中、倾斜和晶状体间距离（ILD）。本实验研究在犹他大学约翰 A. 莫兰眼中心进行。
结果
选择了 9 只眼球，具有不同的大小、主要 IOL 材料/设计和 Soemmering 环形成。在 2 只具有悬韧带断裂的眼中，开环模型表现出轻微的偏心和倾斜。在 4 只眼中观察到三脚架的轻微偏心和倾斜；在 1 只额外的眼中，它是居中的，但稍微倾斜。3 只具有悬韧带断裂的眼睛，其中一个闭环的三脚架位于睫状突后面。在所有情况下，都观察到晶状体之间的 ILD（开环：0.65±0.13 mm；三脚架：0.41±0.12 mm）。
结论
重要的是要考虑与补充 IOL 的睫状沟固定相关的解剖方面。评估的两种设计均表现出适当的居中位置和 ILD。开环设计在后房区域通过突出的后房悬韧带薄弱区具有较小的倾斜风险。
