Khodjaev N S, Bessarabov A N, Sobolev N P, Shkandina Yu V
S.N. Fyodorov National Medical Research Center 'MNTK 'Eye Microsurgery', 59A Beskudnikovsky Blvd., Moscow, Russian Federation, 127486.
Vestn Oftalmol. 2019;135(6):60-66. doi: 10.17116/oftalma201913506160.
Presence of an extensive iris defect requires implantation of artificial iris (AI) to close it. With biometric parameters of the AI being as close to an intact eye as possible, it becomes viable to achieve good clinical and functional results with the surgery.
To validate the optimal biometric parameters of the pupil of artificial iris using methods of clinical and theoretical analysis.
Mathematical modeling was used to determine the main criteria characterizing natural aperture diaphragm of the eye (pupil) which were considered in the theoretical substantiation of optimal biometric parameters of the AI's pupil. Parameters determined during the theoretical stage of the study were used in the development of iris-lens diaphragm (ILD) for clinical application. The study included 6 patients (6 eyes) with post-traumatic aniridia and cataract requiring reconstructive surgery. In the course of the surgery, intraocular lens and ILD were sequentially implanted into the capsular bag using injector system. The patients underwent standard and special ophthalmic examination including optical coherence tomography (OCT) of the central retina before the surgery and after 3 months.
According to mathematical modeling, optimal shape of the ILD pupil was determined to be a circle. The suggested diameter for the ILD pupil is 3.2 mm. The pupil must be located on the optical axis of the eye. Distortions of the retinal image become minimal with pupil's edge thickness of 0.2 mm and cone-shaped profile. After Implantation of the developed ILD with pupil parameters determined during the theoretical substantiation, patients of the study exhibited increased visual acuity and satisfaction with results of the surgery.
The biometric parameters of the ILD pupil determined during the clinical-theoretical study can be used in modern ILD models.
广泛的虹膜缺损需要植入人工虹膜（AI）来封闭。使人工虹膜的生物特征参数尽可能接近完整眼睛，手术实现良好的临床和功能效果就变得可行。
使用临床和理论分析方法验证人工虹膜瞳孔的最佳生物特征参数。
采用数学建模确定表征眼睛自然孔径光阑（瞳孔）的主要标准，这些标准在人工虹膜瞳孔最佳生物特征参数的理论论证中被考虑。研究理论阶段确定的参数用于开发临床应用的虹膜 - 晶状体光阑（ILD）。该研究纳入了6例（6只眼）患有创伤后无虹膜和白内障且需要重建手术的患者。在手术过程中，使用注射器系统将人工晶状体和ILD依次植入囊袋内。患者在手术前和术后3个月接受了包括中央视网膜光学相干断层扫描（OCT）在内的标准和特殊眼科检查。
根据数学建模，确定ILD瞳孔的最佳形状为圆形。建议的ILD瞳孔直径为3.2毫米。瞳孔必须位于眼睛的光轴上。当瞳孔边缘厚度为0.2毫米且呈锥形轮廓时，视网膜图像的失真最小。在植入经理论论证确定瞳孔参数的研发ILD后，该研究的患者视力提高，对手术结果满意度增加。
临床 - 理论研究确定的ILD瞳孔生物特征参数可用于现代ILD模型。
