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儿童人工晶状体植入的结局:一项叙述性综述

The Outcome of Artisan Intraocular Lens Implantation in Children: A Narrative Review.

作者信息

Akbari Mitra

机构信息

Department of Eye, Eye Research Center, Amiralmomenin Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, IRN.

出版信息

Cureus. 2024 May 1;16(5):e59435. doi: 10.7759/cureus.59435. eCollection 2024 May.

Abstract

Aphakia is a condition in which the eye's crystalline lens is not in its proper position because of a perforating injury, surgical removal, dislocation of the lens, or congenital anomaly. The management of aphakia can be either conservative or surgical. Various surgical techniques could be used, including retro pupillary-fixated iris-claw intraocular lenses (IOLs) and anterior-fixated iris-claw IOLs. One of the challenges faced by ophthalmologists is the optical rehabilitation of pediatric aphakic patients because a child's eye is still growing, resulting in fundamental variations in their refractive elements, and the immature visual system faces the risks of amblyopia development in the case of defocus or inequality of visual input between both eyes. There is also the risk of the incidence of side effects that can be accepted in adults but not in children. Finally, accurate postoperative supervision and optical rehabilitation in pediatrics will be more complex than that in adults. This review showed that it is possible to place, replace, and exchange the Artisan IOL with minor surgical trauma. Hence, this procedure can be an acceptable therapeutic method for correcting the developmental refractive changes of the growing aphakic eye. However, some worries are still caused by probable long-term side effects, including endothelial cell loss. Finally, a significant attempt at visual rehabilitation is to treat pediatric aphakia with Artisan IOL.

摘要

无晶状体眼是一种由于穿孔性损伤、手术摘除、晶状体脱位或先天性异常导致眼睛的晶状体不在其正常位置的病症。无晶状体眼的治疗可以是保守治疗或手术治疗。可以使用各种手术技术,包括后房型虹膜爪式人工晶状体(IOL)和前房型虹膜爪式IOL。眼科医生面临的挑战之一是小儿无晶状体眼患者的光学康复,因为儿童的眼睛仍在生长,导致其屈光元件发生根本变化,而且在出现散焦或双眼视觉输入不平等的情况下,未成熟的视觉系统面临弱视发展的风险。还存在一些副作用发生率的风险,这些副作用在成人中可以接受,但在儿童中则不行。最后,儿科术后的精确监测和光学康复将比成人更为复杂。本综述表明,以较小的手术创伤植入、更换和交换Artisan人工晶状体是可行的。因此,该手术可以成为矫正生长中的无晶状体眼发育性屈光变化的一种可接受的治疗方法。然而,包括内皮细胞丢失在内的可能的长期副作用仍然引起一些担忧。最后,视觉康复的一项重大尝试是以Artisan人工晶状体治疗小儿无晶状体眼。

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