Hydrophilic acrylic intraocular lens optic and haptics opacification in a diabetic patient - Bilateral case report and clinicopathologic correlation
Hydrophilic acrylic intraocular lens optic and haptics opacification in a diabetic patient - Bilateral case report and clinicopathologic correlation
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DOI：
10.1016/s0161-6420(02)01265-4
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发表时间：
2002-11-01
期刊：
影响因子：
13.7
通讯作者：
Kaskaloglu, M
中科院分区：
文献类型：
--
作者：
Pandey, SK;Werner, L;Kaskaloglu, M
目的：目的：报道一位糖尿病患者植入的两个不透明的单片亲水性丙烯酸人工晶状体（IOL）的临床病理学和超微结构特征。设计：具有临床病理学相关性的介入性病例报告。背景：一位64岁的白色女性接受超声乳化白内障吸除术并植入单片亲水性丙烯酸透镜（SC 60 B-OUV; Medical Developmental Research，Inc.，Clear Water，FL）于1998年10月在左眼中以及于1999年7月在右眼中。术后最佳矫正视力左眼为20/60，右眼为20/50。2000年6月，由于两个晶状体均呈乳白色、白色乳光，患者视力显著下降。对双眼进行了眼内透镜摘除和更换，摘除的IOL提交给我们的中心进行详细的病理学、组织化学和超微结构评价。他们用茜素红和冯科萨法钙染色，并进行了扫描电子显微镜和能量色散射线光谱，以确定性质的存款导致opacification.Main结果措施：文件的钙存款证实组织化学染色和表面analysis.Results：混浊的IOL被发现是视力下降的原因。混浊涉及左眼的IOL光学部和支撑部分，仅限于右眼的IOL光学部。组织化学和超微结构分析表明，不透明是由钙和磷酸盐的沉积在透镜光学和haptics.Conclusions：有两个功能，区分这种情况下，从以前报道的。这是第一个透镜混浊的临床病理报告，已完全涉及透镜光学部和襻。其次，这两枚植入的IOL记录了第一例双侧病例。这种视神经内和触觉混浊的过程代表不明原因的营养不良性钙化。糖尿病患者似乎更严重，更经常受到透镜混浊的影响。植入这种IOL设计的糖尿病患者的长期随访应由外科医生和制造商维持。(C)2002年由美国眼科学会，公司。
Objective: To report clinicopathologic and ultrastructural features of two opacified single-piece hydrophilic acrylic intraocular lenses (IOLs) explanted from a diabetic patient.Design: Interventional case report with clinicopathologic correlation.Setting: A 64-year-old white female underwent phacoemulsification and implantation of a single-piece hydrophilic acrylic lens (SC60B-OUV; Medical Developmental Research, Inc., Clear Water, FL) in October 1998 in the left eye and in July 1999 in the right eye. The best-corrected visual acuity after surgery was 20/60 in the left eye and 20/50 in the right eye. The patient had a marked decrease in visual acuity in June 2000 as a result of a milky, white opalescence of both lenses. Intraocular lens explantation and exchange was performed in both eyes and the explanted IOLs were submitted to our center for detailed pathologic, histochemical, and ultrastructural evaluation. They were stained with alizarin red and the von Kossa method for calcium, and also underwent scanning electron microscopy and energy dispersive radiograph spectroscopy to ascertain the nature of the deposits leading to opacification.Main Outcome Measures: Documentation of calcium deposits confirmed by histochemical stains and surface analyses.Results: Opacification of the IOL was found to be the cause of decreased visual acuity. The opacification involved both the IOL optic and the haptics in the left eye and was confined to the IOL optic in the right eye. Histochemical and ultrastructural analyses revealed that the opacity was caused by deposition of calcium and phosphate within the lens optic and haptics.Conclusions: There are two features that distinguish this case from those reported earlier. This is the first clinicopathologic report of lens opacification that has involved completely the lens optic and the haptics. Second, these two explanted IOLs document the first bilateral case. This process of intraoptic and haptic opacification represents dystrophic calcification of unknown cause. Diabetic patients appear to be more severely and more often affected by lens opacification. Long-term follow-up of diabetic patients implanted with this IOL design should be maintained by surgeons and manufacturers. (C) 2002 by the American Academy of Ophthalmology, Inc.