Goto S, Yo M, Hayashi T
Department of Ophthalmology, Teikyo University Medical School, Tokyo, Japan.
Jpn J Ophthalmol. 1995;39(2):187-92.
Posterior chamber intraocular lenses (PC-IOL) were implanted in 42 eyes of 24 severely mentally and physically handicapped patients, and the results were analyzed in comparison with implants in conventional patients. The patient eyes included in this study were 21 eyes of 13 severely mentally retarded patients, 19 eyes of 10 Down's syndrome patients, and 2 eyes of a patient suffering from mitochondrial encephalomyopathy. Surgeries had been performed under general anesthesia and resulted in significant improvement in vision and quality of life. Severe postoperative complications occurred in one of the eyes of two patients. However, the fellow eye of these patients, which also received a PC-IOL implantation, showed an uneventful postoperative course. The present study indicated that cataract surgery with PC-IOL in patients with severe mental and physical handicaps should be considered as an appropriate and promising application in spite of the various technical difficulties in the pre- and postoperative management of these patients. It is stressed that proper calibration of IOL power immediately before surgery under general anesthesia and small incision techniques are essential for a successful operation in patients with severe mental and physical handicaps.
对24例严重身心残疾患者的42只眼植入了后房型人工晶状体（PC-IOL），并与常规患者的植入情况进行对比分析。本研究纳入的患眼包括13例重度智力发育迟缓患者的21只眼、10例唐氏综合征患者的19只眼以及1例线粒体脑肌病患者的2只眼。手术均在全身麻醉下进行，术后视力和生活质量均有显著改善。2例患者的其中1只眼出现了严重的术后并发症。然而，这些患者另一只接受了PC-IOL植入的眼睛术后过程平稳。本研究表明，尽管在这些患者的术前和术后管理中存在各种技术困难，但对严重身心残疾患者行PC-IOL白内障手术仍应被视为一种合适且有前景的应用。强调在全身麻醉下手术前即刻准确校准人工晶状体度数以及采用小切口技术对于严重身心残疾患者的手术成功至关重要。
