Quadruple procedure for visual rehabilitation of endothelial decompensation following phakic intraocular lens implantation.
Quadruple procedure for visual rehabilitation of endothelial decompensation following phakic intraocular lens implantation.
复制标题
有晶状体眼人工晶状体植入后内皮失代偿视觉康复的四重手术。
DOI：
10.1016/j.ajo.2014.09.002
复制
发表时间：
2014
影响因子：
4.2
通讯作者：
M. Busin
中科院分区：
文献类型：
--
作者：
Y. Nahum;M. Busin
目的评价人工晶状体植入术、超声乳化术、后房型人工晶状体植入术、后房型剥离自动内皮角膜成形术治疗有晶状体眼人工晶状体植入术后内皮细胞失代偿的临床效果。设计、干预性病例系列。方法：私立医院。研究人群：7例(10只眼)晶状体眼人工晶状体植入术后发生内皮细胞失代偿的患者接受了有晶状体眼人工晶状体植入术、超声乳化摘除、人工晶状体植入术和人工晶状体植入术的联合治疗。主要观察指标：最佳矫正眼镜视力、明显屈光不正、内皮细胞计数、内皮细胞计数。结果术后平均随访25.2±28.6个月(3~84个月)。术后BSCVA≥7/10者6眼，4/10者1眼，2/10以上者3眼，均为近视性黄斑病变或深度弱视。术后平均等值球镜为−3 4±1 2。平均内皮细胞损失率为21.3%±7.7%。1例术后PCIOL有轻微偏心，另1例因术后高度屈光不正需行人工晶状体调换。1例术后发生排斥反应，未计入内皮细胞丢失。结论人工晶状体摘除、DSAEK、白内障摘除、人工晶状体植入术联合手术，术后视力恢复快，视力恢复快，移植物存活率高。
PurposeTo evaluate the clinical outcomes of combined phakic intraocular lens (phakic IOL) explantation, phacoemulsification, posterior chamber intraocular lens (PCIOL) implantation, and Descemet stripping automated endothelial keratoplasty (DSAEK) performed for phakic IOL–related endothelial decompensation.DesignRetrospective, interventional case series.Methodssetting: Private hospital.study population: Ten eyes of 7 patients who developed endothelial decompensation after phakic IOL implantation and were treated with a combined procedure of phakic IOL explantation, phacoemulsification, PCIOL implantation, and DSAEK.main outcome measures: Best spectacle-corrected visual acuity (BSCVA), manifest refractive error, endothelial cell count, and intraoperative and postoperative complications.ResultsMean postoperative follow-up was 25.2 ± 28.6 months (range 3–84 months). BSCVA at last visit was 7/10 or better in 6 eyes, 4/10 in 1 eye, and 2/10 or worse in 3 eyes, of which all had myopic maculopathy or deep amblyopia. Mean postoperative spherical equivalent was −3.4 ± 1.2 diopters. Mean endothelial cell loss in comparison to preoperative donor endothelial cell density was 21.3% ± 7.7%. Minor PCIOL decentration was seen in 1 patient, and IOL exchange was required in another patient owing to high postoperative refractive error. One graft rejection leading to graft failure was seen and was excluded from endothelial cell loss calculation.ConclusionAn operation combining phakic IOL removal, DSAEK, cataract removal, and PCIOL implantation can offer fast visual rehabilitation with good visual results and graft survival.