Fernández-Vigo José Ignacio, Burgos-Blasco Bárbara, De-Pablo-Gómez-de-Liaño Lucía, Almorín-Fernández-Vigo Ignacio, Arriola-Villalobos Pedro, Ruiz-Casas Diego, Macarro-Merino Ana, Fernández-Vigo José Ángel
Department of Ophthalmology, Hospital Clínico San Carlos, San Carlos Health Research Institute (IdISSC), 28040 Madrid, Spain.
Department of Immunology, Ophthalmology and ENT, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain.
Diagnostics (Basel). 2025 Sep 19;15(18):2385. doi: 10.3390/diagnostics15182385.
Anterior segment optical coherence tomography (AS-OCT) has emerged as a crucial imaging technique in ophthalmology, particularly for evaluating intraocular structures and the behavior of phakic and secondary intraocular lenses (IOLs). This narrative review summarizes the latest findings and clinical applications of OCT regarding phakic and secondary IOLs, focusing on their effectiveness, safety, and factors influencing performance. Through a comprehensive analysis of current literature, we explore how OCT facilitates the assessment of IOLs on key anatomical parameters-such as vault, angle configuration, lens centration, tilt, and haptic positioning-essential for optimizing surgical outcomes and minimizing postoperative complications. In phakic IOLs, including posterior chamber lenses such as the Implantable Collamer Lens (ICL, STAAR Surgical, Monrovia, CA, USA) and iris-fixated lenses, such as Artiflex (Ophtec BV, Groningen, The Netherlands), OCT enables precise evaluation of the anterior segment, aiding both candidate selection and long-term monitoring. In secondary implants for aphakia-especially iris-fixated lenses like Artisan (Ophtec BV, Groningen, The Netherlands) and sutureless scleral-fixated lenses such as the Carlevale IOL (Soleko, Rome, Italy)-or those implanted via the Yamane technique, OCT provides high-resolution visualization of haptic fixation, IOL stability, and potential complications, including tilt or decentration. This review also highlights comparative insights between fixation techniques, underscores the need for standardized OCT protocols, and discusses the integration of artificial intelligence tools. In summary, the routine use of OCT in the preoperative and postoperative management of phakic and secondary IOLs has been increasingly incorporated into clinical practice, as it enhances clinical decision-making and improves patient outcomes.
眼前节光学相干断层扫描（AS-OCT）已成为眼科的一项关键成像技术，尤其用于评估眼内结构以及有晶状体眼和二期人工晶状体（IOL）的情况。本叙述性综述总结了OCT在有晶状体眼和二期IOL方面的最新研究结果及临床应用，重点关注其有效性、安全性以及影响性能的因素。通过对当前文献的全面分析，我们探讨了OCT如何有助于评估IOL的关键解剖学参数，如房水腔、房角结构、晶状体中心定位、倾斜度和襻的位置，这些参数对于优化手术效果和减少术后并发症至关重要。在有晶状体眼IOL中，包括后房型晶状体如可植入式角膜接触镜（ICL，STAAR Surgical，美国加利福尼亚州蒙罗维亚）以及虹膜固定型晶状体如Artiflex（Ophtec BV，荷兰格罗宁根），OCT能够精确评估眼前节，有助于筛选候选者和进行长期监测。在无晶状体眼的二期植入物中，特别是虹膜固定型晶状体如Artisan（Ophtec BV，荷兰格罗宁根）和无缝线巩膜固定型晶状体如Carlevale IOL（Soleko，意大利罗马），或者通过山根技术植入的晶状体，OCT能够提供襻固定、IOL稳定性以及潜在并发症（包括倾斜或偏心）的高分辨率可视化图像。本综述还强调了固定技术之间的比较见解，强调了标准化OCT方案的必要性，并讨论了人工智能工具的整合。总之，OCT在有晶状体眼和二期IOL术前及术后管理中的常规应用已越来越多地纳入临床实践，因为它增强了临床决策并改善了患者预后。
