Management of pseudophakic myopic anisometropic amblyopia with piggyback Visian® implantable collamer lens
Management of pseudophakic myopic anisometropic amblyopia with piggyback Visian® implantable collamer lens
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DOI：
10.1111/aos.13203
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发表时间：
2017-03-01
影响因子：
3.4
通讯作者：
Eissa, Sherif A.
中科院分区：
文献类型：
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作者：
Eissa, Sherif A.
目的：评估Visian（R）植入式胶体晶状体（ICL）的肺植入结果，以纠正伪造的肌异构型乳腺异常弱点，并具有肌反应转移和/或原发性折射过度校正。 5-9岁，有白内障手术的史，主要是袋中镜头（IOL）植入，然后进行近视移位和/或折射过度校正和可变度的肛门弱视。所有病例都植入了Piggyback ICL/toric ICL，以纠正近视/近视散光。术前，我们评估了未校正的距离视力（UCVA），校正的距离视力（CDVA），明显的折射球形等效物（MRSE），眼内压（IOP）和内皮细胞密度（ECD）。我们评估了ICL在SLIT灯检查中的位置和拱顶，并通过Scheimpflug断层扫描确认。术后随访时间为第1周，1、3、6、9、12、18和24个月。回流：在所有情况下，未校正的距离视力均提高，CDVA在11只弱视眼（2-4行）中有所改善。在整个2年的随访中，没有室内腹膜际衰落（ILO）的证据。 IOP的早期术后急性升高和由局部β受体阻滞剂控制，两例很复杂。术后急性前葡萄膜炎发生在六只眼中，并由局部类固醇控制。使用Pentacam测量可植入的胶体镜头（ICL）拱顶，平均值为470 +/- 238 MU M.Conclactuly：sulcus植入次级Piggyback ICL的沟以纠正儿童的单方面伪造性近视折衷性误差在所有眼睛的弱视症中都可以忍受。
Purpose: To assess the outcomes of sulcus implantation of the Visian (R) implantable collamer lens (ICL) to correct pseudophakic myopic anisometropic amblyopia with myopic shift and/or primary refractive overcorrection.Methods: Prospective case series enrolled 14 pseudophakic eyes of 14 patients, 5-9 years old, with history of cataract surgery and primary in the bag-intraocular lenses (IOL) implantation, followed by myopic shift and/or refractive overcorrection and anisometropic amblyopia of variable degrees. All cases had implantation of a piggyback ICL/toric ICL, to correct the myopia/myopic astigmatism. Preoperatively, we evaluated the uncorrected distance visual acuity (UCVA), corrected distance visual acuity (CDVA), manifest refraction spherical equivalent (MRSE), intraocular pressure (IOP) and endothelial cell density (ECD). We assessed the position and vaulting of the ICLs on slit lamp examination and confirmed by Scheimpflug tomography. Postoperative followup was at 1st week and 1, 3, 6, 9, 12, 18 and 24 months.Results: Uncorrected distance visual acuity improved in all cases, and CDVA improved in 11 amblyopic eyes (2-4 lines). There was no evidence of interlenticular opacification (ILO) throughout the 2-year follow-up. Two cases were complicated with early postoperative acute elevation of IOP and were controlled with topical beta-blockers. Postoperative acute anterior uveitis occurred in six eyes and controlled by topical steroids. Implantable collamer lens (ICL) vault was measured using Pentacam, with mean value of 470 +/- 238 mu m.Conclusion: Sulcus implantation of the secondary piggyback ICL to correct unilateral pseudophakic myopic refractive error in children was safe, efficient, predictable and well tolerated in management of anisometropic amblyopia in all eyes.