Linaburg Taylor J, Cui Qi N, Armenti Stephen
DEPARTMENT OF OPHTHALMOLOGY, SCHEIE EYE INSTITUTE, UNIVERSITY OF PENNSYLVANIA, PHILADELPHIA, PA.
Adv Ophthalmol Optom. 2024 Aug;9(1):133-151. doi: 10.1016/j.yaoo.2024.02.007. Epub 2024 Mar 15.
THIS REVIEW EXPLORES POST-OPERATIVE CHALLENGES ARISING FROM CATARACT SURGERY, INCLUDING INTRAOCULAR LENS (IOL) DECENTRATION OR DISLOCATION, REFRACTIVE SURPRISES, DYSPHOTOPSIAS, AND IOL OPACIFICATIONS. IOL DECENTRATION OR DISLOCATION IS RARE, HIGHLIGHTING THE NEED FOR CAREFUL MANAGEMENT WITH MONITORING, SURGICAL REPOSITIONING OR LENS EXCHANGE TO ACHIEVE OPTIMAL VISUAL OUTCOMES. REFRACTIVE SURPRISES, ATTRIBUTED TO ERRORS IN IOL CALCULATION AND SELECTION, MAY BE MANAGED CONSERVATIVELY OR SURGICALLY, WITH THE MOST ACCURATE RESULTS ACHIEVED BY LASER VISION CORRECTION. POSITIVE AND NEGATIVE DYSPHOTOPSIAS MAY CONTINUE TO BE INTOLERABLE FOR PATIENTS, AND MAY REQUIRE LENS EXCHANGE AS WELL. IOL OPACIFICATIONS VARY BY IOL MATERIAL AND MAY BE VISUALLY SIGNIFICANT, REQUIRING LENS EXCHANGE. WE UNDERSCORE THE IMPORTANCE OF NUANCED MANAGEMENT AND PROVIDING OPTIMAL PATIENT CARE IN THE ABOVE POST-CATARACT SURGERY AND IOL IMPLANTATION COMPLICATIONS.
本综述探讨了白内障手术后出现的术后挑战,包括人工晶状体(IOL)偏心或脱位、屈光意外、畏光症和人工晶状体混浊。人工晶状体偏心或脱位很少见,这凸显了通过监测、手术复位或晶状体置换进行仔细管理以实现最佳视觉效果的必要性。屈光意外归因于人工晶状体计算和选择中的误差,可采用保守或手术方法处理,激光视力矫正可取得最准确的结果。正负畏光症对患者来说可能仍然难以忍受,可能也需要进行晶状体置换。人工晶状体混浊因人工晶状体材料而异,可能具有明显的视觉影响,需要进行晶状体置换。我们强调在上述白内障手术和人工晶状体植入并发症中进行细致管理并提供最佳患者护理的重要性。