Lincke Joel-Benjamin, Häner Nathanael, Schawkat Megir, Zinkernagel Martin S, Unterlauft Jan Darius
Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland.
Sci Rep. 2025 Jan 9;15(1):1415. doi: 10.1038/s41598-024-83659-y.
To describe the management and clinical course of 12 cases of pseudophakic aqueous misdirection syndrome (AMS). Twelve eyes of 12 Patients diagnosed with pseudophakic AMS between 2021 and 2022 were included. Best-corrected visual acuity, refraction, intraocular pressure (IOP), anti-glaucomatous medication, spectral domain ocular coherence tomography (SD-OCT) and postoperative complications were evaluated. The mean time of AMS onset was 888 days (SD ± 1210, range: 1-2920) after cataract surgery. Treatment with IOP-lowering medication alone was non-sufficient in all followed cases. Laser iridotomy (LIT) was performed in 4 eyes and led to resolution of AMS in 3 eyes. Nine eyes were treated surgically with 23-gauge pars plana vitrectomy and irido-zonulectomy. The most common postsurgical complication was cystoid macular edema (CME), occurring in 30% of cases. AMS is a rare but serious complication after cataract surgery, which can occur many years later. While LIT can be tried as first line treatment, pars plana vitrectomy with irido-zonulectomy is often required to ultimately control IOP in these eyes. A common complication after vitrectomy is CME.
描述12例人工晶状体性房水错向综合征（AMS）的治疗及临床过程。纳入2021年至2022年期间诊断为人工晶状体性AMS的12例患者的12只眼。评估最佳矫正视力、验光、眼压（IOP）、抗青光眼药物、频域光学相干断层扫描（SD - OCT）及术后并发症。AMS发病的平均时间为白内障手术后888天（标准差±1210，范围：1 - 2920天）。在所有随访病例中，单纯使用降眼压药物治疗均不足。4只眼行激光虹膜切开术（LIT），其中3只眼的AMS症状得到缓解。9只眼接受了23G玻璃体切割术联合虹膜 - 晶状体悬韧带切除术。最常见的术后并发症是黄斑囊样水肿（CME），发生率为30%。AMS是白内障手术后一种罕见但严重的并发症，可在多年后发生。虽然可尝试将LIT作为一线治疗，但通常需要行玻璃体切割术联合虹膜 - 晶状体悬韧带切除术来最终控制这些眼的眼压。玻璃体切割术后常见的并发症是CME。
