Lavine Jeremy A, Sharma Sumit
Department of Ophthalmology, Northwestern University, Chicago, Illinois; and.
Cleveland Clinic Foundation, Cole Eye Institute, Cleveland, Ohio.
Retin Cases Brief Rep. 2021 Nov 1;15(6):738-740. doi: 10.1097/ICB.0000000000000906.
To report a case of an opacified scleral-sutured Akreos intraocular lens (IOL) and discuss the technique for surgical removal.
A 27-year-old man presented with blurry vision in the right eye 1 year after trauma, pars plana vitrectomy, glaucoma tube shunt surgery, and a scleral-sutured Akreos AO60 IOL. Examination demonstrated a visual acuity of 20/300, a persistently dilated pupil, 360° of peripheral anterior synechiae, and an opacified IOL. The patient underwent IOL explantation.
Owing to the expected granulation of the Gore-Tex suture, an external approach for suture ligation was not attempted. The suture was identified and ligated nasally with forceps and IOL cutting scissors. The Gore-Tex suture was granulated into the ciliary body temporally and was unable to be identified. The eyelets of the Akreos IOL were ligated to remove the IOL.
Granulation of the Gore-Tex suture into the ciliary body and sclera requires an internal approach for ligation of the suture or eyelets to remove an opacified scleral-sutured Akreos IOL.
报告一例巩膜缝合的Akreos人工晶状体(IOL)混浊病例,并讨论手术取出技术。
一名27岁男性在眼外伤、玻璃体切割术、青光眼引流管植入术以及巩膜缝合Akreos AO60 IOL术后1年,出现右眼视力模糊。检查显示视力为20/300,瞳孔持续散大,360°周边前粘连,以及IOL混浊。患者接受了IOL取出术。
由于预期的Gore-Tex缝线肉芽形成,未尝试外部缝线结扎方法。用镊子和IOL切割剪刀在鼻侧识别并结扎缝线。Gore-Tex缝线在颞侧长入睫状体,无法识别。结扎Akreos IOL的小孔以取出IOL。
Gore-Tex缝线长入睫状体和巩膜时,需要采用内部方法结扎缝线或小孔,以取出混浊的巩膜缝合Akreos IOL。