Apple D J, Craythorn J M, Olson R J, Little L E, Lyman J B, Reidy J J, Loftfield K
Ophthalmology. 1984 Apr;91(4):403-19. doi: 10.1016/s0161-6420(84)34290-7.
Lens implantation is now a highly successful operation. Although follow-up over 5 to 10 years with posterior chamber lenses is incomplete, the complication rate appears to be as low or lower than other lens styles. We present an exception: a clinicopathologic analysis of a globe, enucleated 4 years postoperatively, which in spite of uneventful implantation of a posterior chamber lens, developed neovascular glaucoma. Microscopic studies suggest several mechanisms for this rare complication including deep erosion of a prolene loop into the ciliary body, anterior segment ischemia, and breakdown of the blood-aqueous barrier. Scanning microscopy showed cracking of this deeply embedded loop, a finding we interpret as possible stress cracking and/or oxidation. The more flexible loops now used in modern lenses may decrease the chance of deep erosion. Implantation of a loop in the capsular bag may minimize the danger of both erosion and loop degradation. Patients should be followed long-term in order to recognize and treat these rare, but potentially disastrous complications.
晶状体植入术如今是一项非常成功的手术。尽管对后房型人工晶状体进行5至10年的随访并不完整，但并发症发生率似乎与其他类型的晶状体一样低或更低。我们呈现一个例外情况：对一例术后4年摘除的眼球进行临床病理分析，尽管后房型人工晶状体植入过程顺利，但仍发生了新生血管性青光眼。显微镜研究提示了这种罕见并发症的几种机制，包括聚丙烯袢深入睫状体、眼前节缺血以及血-房水屏障破坏。扫描显微镜显示这个深埋的袢出现了裂纹，我们将这一发现解释为可能的应力开裂和/或氧化。现代晶状体中现在使用的更柔韧的袢可能会降低深入侵蚀的几率。将袢植入囊袋中可将侵蚀和袢降解的风险降至最低。应长期随访患者，以便识别和治疗这些罕见但可能具有灾难性的并发症。
