Auffarth G U, Wesendahl T A, Brown S J, Apple D J
Department of Ophthalmology and Pathology, Medical University of South Carolina, Charleston.
Ophthalmologe. 1994 Aug;91(4):507-11.
In this study we analysed the overall incidence and the types of complications seen after cataract surgery and implantation of posterior chamber intraocular lenses (PC-IOLs) based on a review of 1460 explanted PC-IOLs. Of these explanted PC-IOLs, 1072 (73.4%) were three-piece PMMA IOLs with Prolene haptics, 261 (17.9%) were one-piece all-PMMA IOLs, 81 (5.6%) were silicone IOLs and 46 (3.1%) were of various other designs (multifocal IOLs, disc IOLs etc.). The mean implant duration for all IOLs was 25.57 +/- 29.24 months. The two most important reasons for explantation were IOL decentration (622/1460, 42.6%) and inflammation (347/1460, 23.77%). There was no difference in reasons for explantation between one-piece and three-piece IOLs. Operative techniques such as "can opener" capsulotomy and sulcus fixation have more influence on IOL decentration than the IOL design alone. Modern operative techniques such as continuous curvilinear capsulorhexis, phacoemulsification and symmetrical in-the-bag fixation of "capsular IOLs" should decrease the explantation and complication rate in the future.
在本研究中，我们基于对1460枚取出的后房型人工晶状体（PC-IOL）的回顾，分析了白内障手术及植入PC-IOL后并发症的总体发生率及类型。在这些取出的PC-IOL中，1072枚（73.4%）是带有聚丙烯襻的三件式聚甲基丙烯酸甲酯（PMMA）IOL，261枚（17.9%）是一体式全PMMA IOL，81枚（5.6%）是硅胶IOL，46枚（3.1%）是其他各种设计的IOL（多焦点IOL、盘状IOL等）。所有IOL的平均植入时间为25.57±29.24个月。取出IOL的两个最重要原因是IOL偏心（622/1460，42.6%）和炎症（347/1460，23.77%）。一体式和三件式IOL在取出原因上没有差异。诸如“开罐式”晶状体囊切开术和沟内固定等手术技术对IOL偏心的影响比IOL设计本身更大。诸如连续环形撕囊、超声乳化术以及“囊袋内IOL”的对称囊袋内固定等现代手术技术，未来应能降低取出率和并发症发生率。
