Wills Eye Hospital, Philadelphia, PA; and.
The Wilmer Eye Institute, Johns Hopkins Medicine, Baltimore, MD.
Cornea. 2023 Apr 1;42(4):487-489. doi: 10.1097/ICO.0000000000003206. Epub 2022 Dec 12.
The aim of this study was to describe a case of temporary pupilloplasty during Descemet stripping endothelial keratoplasty to prevent opacification of a hydrophilic acrylic intraocular lens (IOL).
A 60-year-old man presented with corneal edema in the left eye after a traumatic cataract removal and scleral suture fixation of a hydrophilic acrylic IOL (Akreos, Bausch + Lomb, Bridgewater, NJ). Descemet stripping endothelial keratoplasty with temporary pupilloplasty was performed. The pupilloplasty was lysed with neodymium:YAG laser on postoperative day 5 after the air bubble was no longer present.
At 1 year after surgery, the patient did not develop IOL opacification despite the intracameral air used during the surgery.
Opacification of hydrophilic acrylic lenses is a visually significant complication of intracameral gas from endothelial keratoplasty. Our case demonstrates the potential to prevent IOL opacification in a patient with a hydrophilic acrylic IOL by using temporary pupilloplasty.
本研究旨在描述一例在撕囊内皮角膜移植术中行临时瞳孔成形术的病例,以防止亲水性丙烯酸人工晶状体(IOL)混浊。
一名 60 岁男性因外伤性白内障摘除和亲水丙烯酸 IOL(Akreos,Bausch + Lomb,Bridgewater,NJ)巩膜缝线固定后左眼出现角膜水肿。行撕囊内皮角膜移植术联合临时瞳孔成形术。当气泡不再存在时,在术后第 5 天用钕:YAG 激光溶解瞳孔成形术。
术后 1 年,尽管术中使用了眼内气体,但患者的 IOL 并未发生混浊。
亲水性丙烯酸晶状体混浊是内皮角膜移植术中眼内气体的一个严重视觉并发症。我们的病例表明,通过使用临时瞳孔成形术,可预防亲水丙烯酸 IOL 患者发生 IOL 混浊。