Goto S, Hyakutake M
Department of Ophthalmology, Teikyo University Medical School, Itabashi-ku, Japan.
Nippon Ganka Gakkai Zasshi. 1993 Nov;97(11):1307-11.
We implanted a posterior chamber intraocular lens (PC-IOL) in 30 eyes of 17 severely mentally and physically handicapped patients, i.e., 14 eyes of 9 severely mentally retarded patients, 14 eyes of 7 patients with Down's syndrome, and 2 eyes of a mitochondrial encephalomyopathy patient. All surgery was performed under general anesthesia and 3 to 10 post-operative days of hospital care were needed in an ophthalmic ward. A post-operative intensive care unit was not necessary. Severe post-operative complications occurred in 2 eyes of 2 cases. One case was complicated by an iris prolapse, and in another case traumatic wound rupture caused a prolapse of the IOL, vitreous, and retina. However, in both cases, the other eye, which also had a PC-IOL implantation, showed an uneventful post-operative course. Vision and quality of life in all patients seem to have improved. The present observations indicate that cataract surgery with PC-IOL for these patients should be positively considered in spite of difficulties in pre- and post-operative management, and when done, calibration of IOL power immediately before surgery under general anesthesia and small incision techniques are essential.
我们为17名严重身心障碍患者的30只眼睛植入了后房型人工晶状体（PC-IOL），即9名严重智力发育迟缓患者的14只眼睛、7名唐氏综合征患者的14只眼睛以及1名线粒体脑肌病患者的2只眼睛。所有手术均在全身麻醉下进行，术后需要在眼科病房住院护理3至10天。术后不需要重症监护病房。2例患者的2只眼睛出现了严重的术后并发症。1例并发虹膜脱垂，另1例创伤伤口破裂导致人工晶状体、玻璃体和视网膜脱垂。然而，在这两例中，另一只同样植入了PC-IOL的眼睛术后过程顺利。所有患者的视力和生活质量似乎都有所改善。目前的观察结果表明，尽管术前和术后管理存在困难，但对于这些患者，仍应积极考虑进行PC-IOL白内障手术，并且手术时，在全身麻醉下手术前立即校准人工晶状体度数和采用小切口技术至关重要。
