Hettlich H J, Lucke K, Asiyo-Vogel M N, Schulte M, Vogel A
Clinic for Ophthalmology, Medical University of Lübeck, Germany.
J Cataract Refract Surg. 1994 Mar;20(2):115-23. doi: 10.1016/s0886-3350(13)80149-6.
Endocapsular cataract removal and injection of a liquid artificial lens has several advantages, including restitution of accommodation, small corneoscleral incision, a more physiological position of the intraocular lens, and a reduced rate of secondary opacification. Our technique consists of bimanual phacofragmentation followed by injection of a fluid monomeric material that can be polymerized inside the capsular bag by short light exposure. Our study assessed the potential risks of the technique (e.g., heat damage to ocular tissue, light damage to the retina) and investigated the technique in vivo. We performed in vitro experiments on porcine cadaver eyes and an in vivo study on 15 rabbits. After a clinical follow-up of at least 12 weeks, the eyes were investigated histopathologically. During the polymerization process, the highest temperature measured at the posterior lens capsule was 45.1 degrees Celsius for a few seconds. The measured irradiance (0.065 watts per cm2) and the risk of photochemical damage to the retina during 20 seconds of polymerization were comparable to that caused by 1.5 minutes of standard coaxial illumination with the operating microscope. In vivo there were no serious inflammatory reactions except in four cases in which there had been intraoperative problems. The rate of secondary opacification appeared less than in conventional intraocular lens implantation in rabbits, especially when the capsule refilled completely. Retinal damage could not be detected histopathologically. In conclusion, refilling techniques may be successful once appropriate refilling materials become available.
囊内白内障摘除并注入液体人工晶状体有几个优点，包括恢复调节功能、小的角巩膜切口、人工晶状体更符合生理的位置以及继发性混浊发生率降低。我们的技术包括双手操作的晶状体乳化术，随后注入一种流体单体材料，该材料可通过短时间光照在囊袋内聚合。我们的研究评估了该技术的潜在风险（例如，对眼组织的热损伤、对视网膜的光损伤）并在体内对该技术进行了研究。我们在猪尸体眼上进行了体外实验，并对15只兔子进行了体内研究。经过至少12周的临床随访后，对眼睛进行了组织病理学检查。在聚合过程中，后囊膜处测得的最高温度在几秒钟内为45.1摄氏度。聚合20秒期间测得的辐照度（每平方厘米0.065瓦）以及对视网膜的光化学损伤风险与手术显微镜1.5分钟标准同轴照明所造成的相当。在体内，除了4例术中出现问题的情况外，没有严重的炎症反应。继发性混浊的发生率似乎低于兔子常规人工晶状体植入术，尤其是当囊袋完全再充盈时。组织病理学检查未发现视网膜损伤。总之，一旦有合适的再充盈材料，再充盈技术可能会成功。
