Carlson D W, Barad J P, Parsons M R
Wilford Hall Medical Center, San Antonio, Texas, USA.
Am J Ophthalmol. 1995 Oct;120(4):462-70. doi: 10.1016/s0002-9394(14)72660-1.
Visually significant, pigmented cellular membranes may form on intraocular lenses after implantation. We studied a series of patients to determine the onset, visual significance, treatment, and recurrent nature of these pigmented membranes in patients who underwent surgery with silicone lens implantation.
In nine eyes (eight patients) with visually significant pigmented cellular membranes on their Allergan Medical Optics (Irvine, California) silicone intraocular lenses (model SI18NGB or SI26NB), eight underwent combined phacoemulsification, intraocular lens implantation, and trabeculectomy; one underwent phacoemulsification and lens implantation only. We reviewed medical records to identify preoperative, operative, and postoperative similarities and differences in care. Clinical examinations and slit-lamp photographs, over an average of 21.3 +/- 7.2 months (range, 11 to 31 months), documented the effects of different treatment modalities.
The patients sought treatment ten to 20 weeks (mean, 15 weeks) postoperatively. Except for the cellular membranes, each eye was without evidence of inflammation or cystoid macular edema. Subjective complaints decreased, and best-corrected Snellen visual acuity improved with topical corticosteroid therapy alone. Pretreatment best-corrected visual acuities ranged from 20/40 to 20/400 (mean, 20/70 using Snellen fractions) and improved two to eight (mean, five) Snellen lines, to a range of 20/20 to 20/50 (mean, 20/25). All nine eyes had recurrence of the membranes after treatment terminated and required a maintenance regimen of corticosteroid eyedrops.
The pigmented cellular membranes observed on these silicone lenses were visually significant to each patient. The membranes resolved and visual acuity improved with topical corticosteroid treatment alone but recurred in all patients on cessation of treatment.
人工晶状体植入术后眼内可能形成具有视觉意义的色素沉着细胞膜。我们对一系列患者进行了研究，以确定接受硅胶晶状体植入手术的患者中这些色素沉着膜的发生时间、视觉意义、治疗方法及复发情况。
9只眼（8例患者）的爱尔康医疗光学公司（加利福尼亚州欧文市）硅胶人工晶状体（型号SI18NGB或SI26NB）上出现了具有视觉意义的色素沉着细胞膜，其中8例接受了白内障超声乳化吸除、人工晶状体植入联合小梁切除术；1例仅接受了白内障超声乳化吸除及晶状体植入术。我们查阅病历，以确定术前、术中及术后护理的异同。平均随访21.3±7.2个月（范围11至31个月）的临床检查及裂隙灯照片记录了不同治疗方式的效果。
患者术后10至20周（平均15周）寻求治疗。除细胞膜外，每只眼均无炎症或黄斑囊样水肿迹象。仅局部使用皮质类固醇治疗后，主观症状减轻，最佳矫正视力提高。治疗前最佳矫正视力范围为20/40至20/400（平均，使用Snellen视力分数为20/70），提高了2至8行（平均5行），达到20/20至20/50（平均，20/25）。治疗终止后，所有9只眼的细胞膜均复发，需要维持使用皮质类固醇眼药水。
这些硅胶晶状体上观察到的色素沉着细胞膜对每位患者均具有视觉意义。仅局部使用皮质类固醇治疗可使细胞膜消退、视力提高，但所有患者在治疗停止后均复发。
