Nishi O, Nishi K, Mano C, Ichihara M, Honda T
Nishi Eye Hospital, Osaka, Japan.
J Cataract Refract Surg. 1998 Jul;24(7):975-82. doi: 10.1016/s0886-3350(98)80054-0.
To evaluate the technique of refilling the lens capsule with injectable silicone and assess the postoperative findings.
Jinshikai Medical Foundation, Nishi Eye Hospital, Osaka, Japan.
The lens capsules in the eyes of 16 rabbits weighing 1.5 to 2.0 kg were refilled with 0.2 mL of silicone polymer (about 66% bag volume) after endocapsular phacoemulsification through an upper minicircular capsulorhexis 1.5 to 1.8 mm in diameter. The capsule opening was sealed with a silicone plug to prevent leakage of the injected silicone. Main outcome measures were surgical success rate, inflammation, endothelial cell loss, refractive change after pilocarpine 4% instillation, and capsule opacification.
The lens capsule could be refilled in 10 eyes. The failures were caused by capsule rupture during phacoemulsification (n = 3) and profuse leakage of the injected silicone. Silicone that leaked minimally during surgery was easily washed away. Silicone that leaked and polymerized in the anterior chamber postoperatively (n = 3) was easily removed by surgery the following day. Mean endothelial cell loss was 10.2% 1 month after surgery. Aqueous flare intensity was significantly lower on days 2 and 4 than after conventional intraocular lens implantation in a control group. The respective mean preoperative and postoperative refractions were 0.7 diopters (D) +/- 1.0 (SD) and 19.1 +/- 1.0 D and the mean change (difference between the refractions before and after topical application of pilocarpine 4%), -0.4 +/- 0.6 and 1.1 +/- 0.4 D (P < .01). Posterior capsule opacification (PCO) was noted after 3 weeks in all eyes.
Lens capsule refilling and capsular plug use to prevent silicone leakage was shown to be feasible and avoided complications caused by leakage. Refractive changes suggest that the procedure could yield accommodation in primates> Although neodymium: YAG laser capsulotomy did not cause herniation of the injected silicone, PCO prevention is an essential issue in lens refilling because the capsulotomy may annul the attained accommodation.
评估用可注射硅酮重新填充晶状体囊袋的技术，并评估术后结果。
日本大阪西眼科医院金石凯医学基金会。
对16只体重1.5至2.0千克的兔子的眼睛，通过直径1.5至1.8毫米的上方小圆形撕囊进行囊内超声乳化后，用0.2毫升硅酮聚合物（约占囊袋体积的66%）重新填充晶状体囊袋。用硅酮塞封闭囊袋开口以防止注入的硅酮泄漏。主要观察指标为手术成功率、炎症、内皮细胞丢失、滴用4%毛果芸香碱后的屈光变化以及囊袋混浊。
10只眼睛的晶状体囊袋能够成功重新填充。失败原因包括超声乳化过程中囊袋破裂（n = 3）以及注入的硅酮大量泄漏。手术期间少量泄漏的硅酮很容易被冲洗掉。术后在前房内泄漏并聚合的硅酮（n = 3）在第二天通过手术很容易被清除。术后1个月平均内皮细胞丢失率为10.2%。与对照组常规人工晶状体植入术后相比，术后第2天和第4天房水闪光强度明显更低。术前和术后各自的平均屈光度分别为0.7屈光度（D）±1.0（标准差）和19.1±1.0 D，平均变化（局部应用4%毛果芸香碱前后屈光度的差值）为 -0.4±0.6和1.1±0.4 D（P <.01）。所有眼睛在3周后均出现后囊膜混浊（PCO）。
晶状体囊袋重新填充及使用囊袋塞防止硅酮泄漏被证明是可行的，并且避免了由泄漏引起的并发症。屈光变化表明该手术可能在灵长类动物中产生调节功能>尽管钕:钇铝石榴石激光晶状体囊切开术未导致注入的硅酮疝出，但防止PCO是晶状体重新填充中的一个重要问题，因为囊切开术可能会消除所获得的调节功能。
