Delayed postoperative opacification of foldable hydrophilic acrylic intraocular lenses
Delayed postoperative opacification of foldable hydrophilic acrylic intraocular lenses
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DOI：
10.1002/jbm.b.31758
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发表时间：
2011-02-01
影响因子：
3.4
通讯作者：
Xie, Lixin
中科院分区：
文献类型：
--
作者：
Huang, Yusen;Xie, Lixin
白内障超声乳化及折叠式人工透镜植入术在眼科临床上几乎是一种常规手术。亲水性丙烯酸（水凝胶）人工晶状体（IOL）术后晚期混浊已有报道，但外观与我们的发现不同。我们报告的临床，病理，超微结构和光谱分析的折叠水凝胶人工晶状体经历后期浑浊导致视力障碍。这项回顾性研究包括486例（550只眼）植入折叠式水凝胶后段IOL的患者。发现3例（3只眼）IOL混浊。由于严重的视觉障碍，更换了三个晶状体，并使用光学显微镜、扫描电子显微镜和能量色散X射线（EDX）光谱进行了检查。在1例患者中对与混浊IOL接触的囊膜进行了切口活检。植入水凝胶IOL与诊断浑浊之间的平均间隔为35.3个月（范围：34-36个月）。3例均为安静前房。术后无明显后囊膜混浊，3例更换人工晶状体者最佳矫正视力均在20/25以上。显微镜分析显示，混浊IOL的表面和基质上均存在多个细小颗粒状结构。EDX分析表明，钙和磷的存在是在颗粒结构。囊膜的组织学检查未发现任何钙盐或特殊病理交换的证据。应开展进一步研究，以确定这一现象的发生率和可能的机制。(C)2010 Wiley Periodicals，Inc. J Biomed Mater Res Part B：Appl Biomater 96 B：386-391，2011.
Phacoemulsification and implantation of a foldable intraocular lens for cataract is almost a routine procedure in ophthalmic practice. Late postoperative opacification of hydrophilic acrylic (hydrogel) intraocular lenses (IOLs) has been reported, but the appearance differs from our findings. We report clinical, pathologic, ultrastructural, and spectroscopic analyses of foldable hydrogel IOLs undergoing late opacification resulting in visual disturbances. This retrospective study comprised 486 patients (550 eyes) who had implantation of a foldable hydrogel posterior IOL. Three cases (three eyes) had been found to have opacification of the IOLs. The three lenses were exchanged because Of significant visual disturbances, and were examined using light microscopy, scanning electron microscopy and energy dispersion X-ray (EDX) spectroscopy. Incisional biopsies of the capsular membrane in contact with the opacified IOL were performed in one patient. The mean interval between implantation of the hydrogel IOLs and the diagnosis of opacification was 35.3 months (range, 34-36 months). All three of the cases had quiet anterior chamber. No obvious posterior capsular opacification were found. The best corrected visual acuity of the three cases who had exchanged IOLs were all 20/25 or better. Microscopic analysis revealed multiple, fine, granular structures both on the surface and matrix of the opacified IOLs. EDX analysis showed the presence of calcium and phosphorous were within the granular structures. Histological examination of capsular membrane did not reveal any evidence of calcium salts or special pathological exchanges. Further studies should be undertaken to determine the incidence and possible mechanisms of this phenomenon. (C) 2010 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 96B: 386-391, 2011.