Department of Ophthalmology, Université de Montréal, Montréal, Canada; Department of Ophthalmology, Centre Hospitalier de l'Université de Montréal, Montréal, Canada.
Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Canada.
Ophthalmology. 2021 Nov;128(11):e186-e194. doi: 10.1016/j.ophtha.2020.07.004. Epub 2020 Jul 8.
As cataract surgery has evolved, intraocular lens (IOL) complications are rare. The purpose of this review was to report the incidence, diagnosis, and management of IOL decentrations, uveitis-glaucoma-hyphema (UGH) syndrome, IOL opacifications, and refractive surprises. Literature review was performed by searching PubMed, MEDLINE, EMBASE, and the Cochrane Controlled Trial Database and the reference lists of original studies as well as reviews. Intraocular lens decentrations and dislocations can appear at any time, particularly in patients with predisposing factors such as pseudoexfoliation, prior vitreoretinal surgery, or trauma. Recognizing when they require surgical intervention for UGH or to improve visual function is critical in limiting long-term sequela. Intraocular lens opacifications such as glistenings rarely require intervention, but others, such as subsurface nanoglistenings, calcifications, or discolorations, may require IOL exchange. Finally, despite our best efforts to enhance measurements and IOL calculations, refractive surprises still occur. Intraocular lens complications are uncommon with modern cataract surgery. A number of these complications require proper identification and care to optimize patient outcomes.
随着白内障手术的发展，眼内人工晶状体（IOL）并发症较为罕见。本文旨在报告 IOL 偏心、葡萄膜炎-青光眼-前房积血（UGH）综合征、IOL 混浊和屈光意外的发生率、诊断和处理。通过检索 PubMed、MEDLINE、EMBASE 和 Cochrane 对照试验数据库以及原始研究和综述的参考文献，进行文献回顾。IOL 偏心和脱位可随时发生，尤其是在存在特发性因素（如假性剥脱、既往玻璃体视网膜手术或外伤）的患者中。认识到何时需要手术干预 UGH 或改善视力功能对于限制长期后遗症至关重要。IOL 混浊，如闪光，很少需要干预，但其他混浊，如次表面纳米闪光、钙化或变色，可能需要更换 IOL。最后，尽管我们尽最大努力提高测量和 IOL 计算的准确性，仍会出现屈光意外。现代白内障手术中，IOL 并发症并不常见。许多这些并发症需要正确识别和护理，以优化患者的结局。
