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1.
Over a period of 27 months, November 1983 to February 1986, 75 eyes obtained postmortem with posterior chamber intraocular lenses (IOLs) were examined at the Center for Intraocular Lens Research, University of Utah Health Sciences Center. These IOLs were studied by histopathological techniques to determine the location of the loops. The most common combination, found in 47% of the specimens, was one loop in the lens capsular sac (bag) and one loop in the ciliary sulcus. In 32% of the specimens, both loops were in the capsular sac; in 17%, both loops were in the ciliary sulcus. Compared to results observed in other autopsy studies, in which capsular fixation was documented in less than 3% of cases, these findings reflect a trend toward capsular sac (in-the-bag) implantation of open-looped posterior chamber IOLs.  相似文献   

2.
We illustrate, from the pathologist's viewpoint, the configuration of posterior chamber lens loops within the eye. The final configuration of these loops is often a "C" shape, particularly following capsular fixation. When one or both loops are placed in the ciliary sulcus, where tissue resistance to loop compressive forces is less than in the capsular sac, an invagination or erosion of the loop into the ciliary body stroma or ciliary muscle frequently occurs. Although a surgeon should first and foremost choose a lens design with which he or she is comfortable in terms of ease of implantation and good clinical results, our pathological observations indicate that a subtle compromise in loop configuration might provide a more physiologically correct configuration in the eye, particularly for those who prefer in-the-bag implantation. Most surgeons prefer a lens design that will provide adequate fixation in the ciliary sulcus if an attempted capsular sac implantation is not successful.  相似文献   

3.
PURPOSE: This paper presents the intraoperative complications in pediatric cataract surgery with IOL implantation and their influence on fixation place. MATERIAL AND METHODS: 384 eyes of 276 children undergone operative procedure for cataract. Anterior capsulorhexis, lens cortical aspiration, primary posterior capsulorhexis with anterior vitrectomy and IOL implantation were done in all eyes. The place of IOL implantation was capsular sac or ciliary sulcus. RESULTS: There were no serious intraoperative complications but in cases with large anterior (5.2%) and posterior (14.6%) radial capsule tears, vitreous loss (12.3%), and hemorrhage (5.5%) to anterior and posterior chamber the IOL was fixated at ciliary sulcus (in 37.5%). CONCLUSIONS: The surgical procedure is useful and safe in the management of pediatric cataract. Location of an IOL in the ciliary sulcus in a child, is acceptable. To avoid decentration in this cases, we recommend rigid PMMA IOLs.  相似文献   

4.
The eyes of an 89-year-old male were obtained for postmortem examination five months after implantation of a foldable silicone elastic lens implant. Two months after surgery, the implant had been repositioned from capsular bag to ciliary sulcus fixation to correct postoperative decentration and tilt. Pathological examination showed both haptics located in the ciliary sulcus. There was no significant inflammatory reaction in the adjacent uveal tissue and no erosion of the haptics into the iris or ciliary body.  相似文献   

5.
The effect of posterior chamber intraocular lens (IOL) dimensions, design, style, loop fixation, and anterior capsular tears on decentration were investigated in an experimental model. Nine posterior chamber IOLs of various designs and styles with loop diameters between 12.0 and 14.0 mm and optic diameters between 5.0 and 7.0 mm were implanted in human eyes obtained post mortem. Symmetrical and asymmetrical fixation were investigated in eyes with and without radial tears using the Miyake posterior view technique. Location of IOL loops proved to be the most significant factor in IOL decentration. Decentration was least with symmetrical bag/bag fixation and no radial tears (mean = 0.20 +/- 0.05 mm). Asymmetrical bag/sulcus fixation in the presence of anterior capsular tears was associated with the highest decentration rate (mean 0.68 +/- 0.28 mm). Optic size and total loop diameter had no apparent effect on IOL centration in the immediate postoperative period.  相似文献   

6.
We present a retrospective study on the incidence of visually impairing secondary posterior capsule opacification following fixation of an intraocular lens implant either in the ciliary sulcus or the capsular bag. One hundred patients in each group were evaluated 3 1/2 to 3 3/4 years following uncomplicated extracapsular cataract extraction. Only implants with convex-plane optics and forward angulated haptics were used. The incidence of capsular opacification was 20% in eyes with sulcus fixation as opposed to 14% for those with capsular bag fixation. This difference was statistically not significant. The difference in average postoperative interval until development of the secondary cataract (21 months for sulcus, 28 months for capsular bag fixation) or the age of patients with capsular opacification was statistically not significant either. However, it was noted that of the younger patients, between 40 and 50 years at the time of operation, only those with sulcus fixated implants developed secondary cataracts.  相似文献   

7.
目的评价晶状体囊袋张力环在白内障合并晶状体半脱位中行晶状体超声乳化吸出术中的应用价值。方法对15例(15眼)合并晶状体半脱位的白内障行晶状体超声乳化吸出术,术中连续环行撕囊后植入晶状体囊袋张力环,进行超声乳化吸出,囊袋内植入后房型人工晶状体,对晶状体半脱位范围>1/2圆周者,将囊袋张力环用缝线固定在悬韧带离断一侧巩膜壁上。结果术中人工晶状体植入囊袋内13眼,植入睫状沟2眼;所有植入的人工晶状体基本处于正位。结论在白内障合并晶状体半脱位中行晶状体超声乳化吸出术中植入囊袋张力环是安全有效的方法,它有利于保持囊袋的完整,便于手术操作,防止人工晶状体的偏位,减少手术并发症。  相似文献   

8.
囊袋张力环在晶状体半脱位超声乳化白内障吸除术中的应用   总被引:23,自引:3,他引:20  
Liu Y  Liu Y  Wu M 《中华眼科杂志》2002,38(5):262-264
目的:探讨将囊袋张力环植入晶状体半脱位的囊袋内进行超声乳化白内 障吸除术的安全性。方法:对13例(14只眼)合并晶状体半脱位(脱位范围1/3-3/4象限)的白内障患者行超声乳化白内障吸除术,术中注/吸晶状体皮质时,将囊袋张力环送入晶状体囊袋内,对脱位范围>1/2象限者,将囊袋张力环用缝线固定在巩膜上。结果:术中人工晶状体植入晶状体囊袋内11只眼,植入睫状沟3只眼;术后人工晶状正位12只眼,人工晶状体轻度倾斜2只眼;术中常见并发症为囊袋撕裂和玻璃 体脱出。结论:囊袋张力环是超声乳化白内障吸除术治疗白内障合并晶状体半脱位患者的新型辅助工具,它具有提高手术安全性,防止人工晶状体偏位,减少手术并发症的优点。  相似文献   

9.
A modified technique is presented for transscleral suture fixation of posterior chamber intraocular lenses for aphakic correction in cases with inadequate capsular support. An ab externo approach for suture externalization is described that minimizes intraocular manipulation and facilitates accurate placement of haptics in the ciliary sulcus, thereby reducing the risk of lens tilt and decentration. This technique eliminates intraocular suture knots and reduces the amount of time the globe is open during surgery by creating two intraocular suture loops in preparation for posterior chamber intraocular lens placement before creating a limbal incision.  相似文献   

10.
The current trend toward implantation of posterior chamber lenses within the capsular bag rather than the ciliary sulcus seems logical in light of the increasing evidence of uveal damage from sulcus fixated posterior chamber lenses. However, long-term, successful capsular bag fixation has not been demonstrated with current popular looped lenses of either flat or angulated styles. This report evaluated a new gull-wing loop design that seems to have advantages of both planar and angulated loop styles for support of posterior chamber lenses.  相似文献   

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