Nishi O, Nishi K, Mano C, Ichihara M, Honda T
Nishi Eye Hospital, Osaka, Japan.
Arch Ophthalmol. 1997 Apr;115(4):507-10. doi: 10.1001/archopht.1997.01100150509010.
To investigate control of the capsular shape by determining the ability of the lens capsule to mold injected silicone and to evaluate the relationship among the volume of silicone injected, refraction, and the amplitude of accommodation.
After endocapsular phacoemulsification following an upper, minicircular capsulorhexis, the lens capsule of a pig eye was refilled with a silicone mixture that polymerizes in vitro in 2 hours. The minicircular capsulorhexis opening was sealed by a small silicone plug to prevent leakage. The anterior capsule curvature and refraction of the lens were measured by a Scheimpflug camera and lensometer, respectively, with and without zonular tension. Zonular tension was created using a ciliary ring sutured to the ciliary bodies and expanded.
The mean (+/- SD) anterior curvature of the lenses without zonular tension was 6.50 +/- 0.07 mm after 17 hours and 6.54 +/- 0.04 mm after 42 hours; with zonular tension it was 7.01 +/- 0.11 mm and 7.23 +/- 0.24 mm, respectively. The curvature became flatter when zonular tension was applied or steeper when zonular tension was abolished momentarily during measurements after 17 hours, but after 42 hours the curvature was unaffected by the application or removal of zonular pressure. The mean (+/- SD) amplitude of accommodation (the difference between refraction without zonular tension and that with it) was 3.2 +/- 0.5 diopters (D), 6.1 +/- 1.8 D, 4.8 +/- 0.8 D, and 2.8 +/- 1.3 D, when the lens was refilled with a silicone volume corresponding to 45%, 55%, 75%, and 95%, respectively, of the mean normal lens volume.
The lens capsule possesses some ability to mold the injected silicone during its polymerization. When the eye is atropinized, the lens capsule may conform to its nonaccommodated state. Accommodation could be obtained by various degrees of refilling. Moderate refilling yields a greater amplitude of accommodation than does more complete refilling. Using a silicone plug to seal the capsular opening facilitates lens refilling with excellent reproducibility and seems to be useful in research.
通过测定晶状体囊膜对注入硅胶的塑形能力来研究囊膜形状的控制，并评估注入硅胶的体积、屈光度和调节幅度之间的关系。
在上方小环形撕囊后进行囊内超声乳化术，用一种在体外2小时内聚合的硅胶混合物重新填充猪眼的晶状体囊膜。小环形撕囊开口用一个小硅胶塞封闭以防止渗漏。分别使用眼前节分析仪和验光仪在有和没有悬韧带张力的情况下测量晶状体前囊膜曲率和屈光度。通过将睫状环缝合到睫状体并扩张来产生悬韧带张力。
在17小时后，无悬韧带张力时晶状体的平均（±标准差）前曲率为6.50±0.07mm，42小时后为6.54±0.04mm；有悬韧带张力时分别为7.01±0.11mm和7.23±0.24mm。在17小时后测量期间，施加悬韧带张力时曲率变平，或暂时消除悬韧带张力时曲率变陡，但42小时后，曲率不受悬韧带压力施加或去除的影响。当晶状体分别用相当于正常晶状体平均体积45%、55%、75%和95%的硅胶体积重新填充时，平均（±标准差）调节幅度（无悬韧带张力时的屈光度与有悬韧带张力时的屈光度之差）分别为3.2±0.5屈光度（D）、6.1±1.8D、4.8±0.8D和2.8±1.3D。
晶状体囊膜在硅胶聚合过程中具有一定的塑形能力。当眼睛使用阿托品散瞳时，晶状体囊膜可能符合其非调节状态。通过不同程度的重新填充可获得调节。适度重新填充比更完全重新填充产生更大的调节幅度。使用硅胶塞封闭囊膜开口有助于晶状体重新填充，具有良好的可重复性，似乎对研究有用。
