Ota Akiko, Ota Ichiro, Kachi Shu, Miyake Goichiro, Miyake Kensaku, Kondo Mineo
Department of Ophthalmology, Mie University Graduate School of Medicine, Tsu, Japan.
Shohzankai Medical Foundation, Miyake Eye Hospital, Nagoya, Japan.
Am J Ophthalmol Case Rep. 2022 Jun 11;27:101615. doi: 10.1016/j.ajoc.2022.101615. eCollection 2022 Sep.
To report our findings in a case that had an accumulation of a translucent fluid between the intraocular lens (IOL) and posterior lens capsule one day after vitrectomy for a vitreous hemorrhage.
A 67-year-old woman was diagnosed with diabetes 20 years before the vitrectomy and was treated with panretinal photocoagulation (PRP) for proliferative diabetic retinopathy (PDR) 14 years earlier. She underwent cataract surgery with an implantation of an IOL 4 years earlier. She was referred to our hospital because of a vitreous hemorrhage, and we performed uneventful vitrectomy. However, the day after the operation, a translucent liquid substance that resembled liquefied aftercataract was observed in the lens capsule bag. With time, the liquid substance became cloudy. The opacification progressed for two years after the vitrectomy, and her visual acuity decreased. We then performed neodymium: YAG (Nd: YAG) laser posterior capsulotomy, and the cloudy liquid dispersed into the vitreous and the visual acuity improved.
Our findings indicate that liquified aftercataract-like substance can form after vitrectomy in a pseudophakic eye. We suggest that the aqueous humor might flow into the space behind the IOL during or just after the vitrectomy and was trapped behind the IOL optics. Then, the proliferating lens epithelial cells might be dissolved forming the white liquid substance immediately after the surgery.
报告1例玻璃体切除术后1天，人工晶状体（IOL）与晶状体后囊膜之间积聚半透明液体的病例的研究结果。
一名67岁女性在玻璃体切除术前20年被诊断为糖尿病，14年前因增殖性糖尿病视网膜病变（PDR）接受了全视网膜光凝（PRP）治疗。4年前她接受了白内障手术并植入了IOL。因玻璃体出血转诊至我院，我们顺利进行了玻璃体切除术。然而，术后第1天，在晶状体囊袋内观察到一种类似液化后发性白内障的半透明液体物质。随着时间的推移，液体物质变得混浊。玻璃体切除术后混浊进展了两年，她的视力下降。然后我们进行了钕：钇铝石榴石（Nd：YAG）激光后囊切开术，混浊液体分散到玻璃体中，视力提高。
我们的研究结果表明，假晶状体眼玻璃体切除术后可形成液化后发性白内障样物质。我们认为，在玻璃体切除术期间或刚结束后，房水可能流入IOL后方的间隙，并被困在IOL光学部后方。然后，增殖的晶状体上皮细胞可能在手术后立即溶解形成白色液体物质。
