Mawas E
Klin Monbl Augenheilkd. 1979 Jun;174(6):885-90.
To become an implant surgeon means that one is ready to accept some opposition from part of the profession as well as to known all the shortcomings of conventional cataract extraction. A good knowledge of the history of implantation is necessary to avoid past errors in the shape, manufacture sterilization and in the locus of insertion of the intra-ocular lens. At the start few indications will be retained mainly unilateral cataracts traumatic or not, the aim being restoration of a full binocular vision. The interest of the test of Pulfrich is stressed for the follow up of cataract. A large number of contra-indications will be respected mainly corneal dystrophics or degeneration, uveitis, myopia, detachment and diabetes. The would-be implant surgeon has to train in modern extracapsular cataract extraction, learn the refinements of implantation technique with a full and constant respect of the corneal endothelium. He also should be able to cope with eventual complications and to suture the implant to the iris. He has at first to limit his choice to a small number of implant models which have proved safe: the iris clip and iridocapsular models of C. D. Binkhorst and the slotted-medallion of J. G. F. Worst. Experience will allow in time widening of indications and new improvements of technique.
成为一名植入手术医生意味着要准备好接受行业内部分人的反对,也要了解传统白内障摘除术的所有缺点。熟悉植入手术的历史对于避免在人工晶状体的形状、制造、消毒以及植入位置方面重蹈覆辙很有必要。刚开始时,适应症会比较有限,主要是单侧白内障,无论是否为外伤性,目的是恢复双眼的完整视力。强调了普尔弗里希试验对白内障随访的重要性。要遵守大量的禁忌症,主要是角膜营养不良或变性、葡萄膜炎、近视、视网膜脱离和糖尿病。未来的植入手术医生必须接受现代囊外白内障摘除术的培训,在充分且始终尊重角膜内皮的情况下学习植入技术的精细之处。他还应该能够应对可能出现的并发症,并将植入物缝合到虹膜上。起初,他必须将选择范围限制在少数已被证明安全的植入物模型上:C.D.宾克霍斯特的虹膜夹和虹膜囊袋模型以及J.G.F.沃斯特的开槽奖章模型。随着时间的推移,经验会使适应症扩大,技术也会有新的改进。