Ma Shang-Te, Yang Chung-May, Hou Yu-Chih
Department of Ophthalmology, National Taiwan University Hospital, University College of Medicine, Taipei, Taiwan.
Department of Ophthalmology, Cathay General Hospital, Taipei, Taiwan.
Taiwan J Ophthalmol. 2018 Jan-Mar;8(1):49-51. doi: 10.4103/tjo.tjo_78_17.
Intraocular lens (IOL) opacification is rare but may occur after non-Descemet stripping automated endothelial keratoplasty (n-DSAEK) or intravitreal air injection after pars plana vitrectomy (PPV). We reported two cases of IOL opacification within the pupillary region. Chart was retrospectively reviewed. The predisposing factors and the visual acuity were analyzed. The opacification was evaluated by anterior segment optical coherence tomography (AS-OCT). A 68-year-old healthy woman with pseudophakic bullous keratopathy underwent uneventful n-DSAEK in the right eye. Postoperative vision was 20/40. Nine months after surgery, fine granular deposits were seen in the anterior surface of IOL. The vision decreased to 20/50 but remained stable during 3-year follow-up. A 61-year-old man with diabetes mellitus received PPV and silicone oil tamponade for retinal detachment and vitreal hemorrhage after cataract surgery in the right eye. Removal of silicone oil and intravitreal air injection was performed, and postoperative vision was 20/100. Granular deposits were observed in hydrophobic acrylic IOL 1 month after surgery. The visual acuity decreased to 20/120. AS-OCT revealed hyperreflective materials in the anterior surface of IOL in both cases. An uncommon phenomenon of IOL opacification in the pupil region may occur after n-DSAEK or PPV, which may be associated with intraocular air injection or systemic diseases.
人工晶状体（IOL）混浊较为罕见，但可发生于非Descemet膜剥除自动角膜内皮移植术（n-DSAEK）后或玻璃体切除术后（PPV）玻璃体内注射空气后。我们报告了两例瞳孔区域内人工晶状体混浊的病例。对病历进行了回顾性分析。分析了诱发因素和视力情况。通过眼前节光学相干断层扫描（AS-OCT）对混浊情况进行评估。一名68岁健康的假晶状体大泡性角膜病变女性右眼顺利接受了n-DSAEK手术。术后视力为20/40。术后9个月，在人工晶状体前表面可见细小颗粒状沉积物。视力降至20/50，但在3年随访期间保持稳定。一名61岁患有糖尿病的男性右眼白内障手术后因视网膜脱离和玻璃体积血接受了PPV及硅油填充。进行了硅油取出和玻璃体内空气注射，术后视力为20/100。术后1个月在疏水丙烯酸人工晶状体中观察到颗粒状沉积物。视力降至20/120。AS-OCT显示两例患者人工晶状体前表面均有高反射物质。n-DSAEK或PPV术后可能会出现瞳孔区域人工晶状体混浊这一罕见现象，这可能与玻璃体内注射空气或全身性疾病有关。
