首页 | 本学科首页   官方微博 | 高级检索  
相似文献
 共查询到10条相似文献,搜索用时 156 毫秒
1.
Radial anterior capsular tears frequently occur in posterior-chamber iris-plane phacoemulsification cases. These tears extend to the capsular bag equator and can allow the knee of an in-the-bag posterior chamber intraocular lens (IOL) to unfold a smaller anterior capsular remnant. This unfolding can allow the knee of the IOL loop to extend beyond the capsular equator, leading to IOL decentration. Typical anterior capsular radial tear configurations along with guidelines for IOL design selection and orientation after recognition of these tears are presented. Proper IOL centration was achieved in 255 of 262 patients (97%) in a study observing these guidelines.  相似文献   

2.
PURPOSE: To investigate the position of 3-piece foldable intraocular lenses (IOLs) after piggyback implantation for high hyperopia. SETTING: University Eye Hospital, Johann Wolfgang Goethe University, Frankfurt am Main, Germany. METHODS: Eight eyes of 5 highly hyperopic patients had phacoemulsification and implantation of 2 foldable IOLs. In 3 eyes, both IOLs were implanted in the capsular bag. In 5 eyes, 1 IOL was placed in the capsular bag and the second IOL in the ciliary sulcus. Intraocular lens optic tilt and decentration, combined thickness of both IOLs, and anterior chamber depth (ACD) were measured postoperatively over a period of 18 months using Scheimpflug photography. RESULTS: All eyes with both IOLs in the capsular bag showed interpseudophakic opacification, with a mean increase in combined IOL thickness of 0.4 mm, a decrease in ACD of 0.3 mm, and a corresponding hyperopic shift of 4.00 diopters. Eyes in which the anterior IOL was placed in the ciliary sulcus showed no changes in refraction or combined IOL thickness. In these eyes, the anterior IOL had a higher mean decentration (0.49 mm +/- 0.20 [SD] after 12 months) than the posterior IOL (0.21 +/- 0.13 mm after 12 months). CONCLUSIONS: Piggyback IOL implantation with placement of 2 foldable IOLs in the capsular bag can be followed by a hyperopic shift that may be caused in part by displacement of the IOLs. Placement of the anterior IOL in the ciliary sulcus can lead to higher decentration of this IOL.  相似文献   

3.
PURPOSE: To evaluate the incidence of intraocular lens (IOL) decentration and posterior capsule opacification (PCO) after implantation of a three-piece posterior chamber silicone IOL in a series of eyes examined postmortem. METHODS: Twenty-three pseudophakic enucleated human cadaver eyes, implanted with AMO SI40NB IOLs after phacoemulsification, were analyzed. Eyes obtained postmortem were sectioned at the equatorial plane and the anterior segment photographed from a posterior view. Location of IOL optic and haptics, type of fixation, and centration of IOL was evaluated. PCO was graded and the presence of Nd:YAG laser posterior capsulotomy was noted. RESULTS: Mean age at the time of surgery was 77.83 years, mean time since implantation was 18.26 months. In all the eyes examined, IOL haptics were positioned in the capsular bag. Mean decentration was 0.20+/-0.16 mm. No correlation was found between IOL decentration and time since implantation. The degree of peripheral PCO ranged from none (13.0%) to mild (39.1%) to moderate (26.1%) to severe (21.7%). The degree of central PCO ranged from none (52.2%) to mild (30.4%) to moderate (4.3%). Three patients (13.0%) underwent Nd:YAG laser posterior capsulotomy. CONCLUSIONS: A very good centration can be obtained when silicone AMOSI40NB IOLs are correctly implanted with the haptics inside the capsular bag. About half of the implants showed no central PCO while Nd:YAG laser posterior capsulotomy rates documented a relatively low PCO 18 months after surgery. A careful in the bag haptics placement is needed in order to reduce the IOL decentration and to prevent central PCO.  相似文献   

4.
Radial tears at the edge of an anterior capsulectomy are often associated with the occurrence of intraocular lens (IOL) loops coming out of the capsular bag with subsequent IOL decentration. We analyzed the incidence of radial tear formation in 40 human eyes obtained postmortem. These eyes were randomly assigned to four groups: "can opener," linear capsulotomy, capsulopuncture ("postage stamp"), and continuous curvilinear capsulorhexis (CCC). The CCC appeared to be much less likely to be associated with anterior capsular radial tears as opposed to the other three techniques. With the nucleus expression technique used in this study, radial tears occurred in all cases of "can opener," linear capsulotomy and capsulopuncture, whereas no tears occurred with the CCC technique. The results of this study show that CCC is currently the best available anterior capsulectomy procedure for minimizing the incidence of radial tears and sequelae such as decentration.  相似文献   

5.
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   

6.
Two hundred fifty consecutive postmortem eyes containing posterior chamber intraocular lenses (PC IOLs) were analyzed according to the presence and number of radial anterior capsular tears. Over 90% of cases had been done with the "can opener" technique. A surprisingly high percentage of cases, 86%, had one to five radial tears. Furthermore, our analysis showed that the most consistent and most permanent in-the-bag fixation was achieved when only one tear or less was present in the anterior capsule. Because this study shows that the incidence of radial tears is very high after nuclear expression with "can opener" capsulectomy, it provides a scientific basis supporting the transition toward the continuous circular capsulorhexis technique that is slowly evolving. The latter technique has been shown to minimize the incidence of anterior capsular radial tears. This may ultimately serve to decrease the incidence of PC IOL decentration, an important goal if the use of bimultifocal IOLs and IOLs with small or aspheric optics is to be successful.  相似文献   

7.
Yang J  Lu Y  Luo Y  Wang L 《中华眼科杂志》2007,43(6):519-524
目的评价在晶状体悬韧带异常情况下行超声乳化白内障吸除术时植入囊袋张力环(CTR)来提供晶状体囊袋支持的中长期临床效果。方法对2003年1月至2004年7月期间因晶状体悬韧带松弛或部分断裂或合并白内障在我院行超声乳化白内障吸除及CTR和人工晶状体(IOL)植入术的19例患者(22只眼)进行为期2年的随访。随访指标为最佳矫正视力和屈光度数、眼压、CTR和IOL及囊袋复合体的位置、晶状体后囊膜混浊(PCO)和晶状体囊袋的收缩程度。应用眼前节成像系统Pentacam采集各眼的Scheimpflug图像,分析术后1、6、12和24个月IOL的偏心值与倾斜度。结果术后2年随访结果:末次随访最佳矫正视力较术前提高≥2行者20只眼(90.9%),提高1行者2只眼(9.1%)。CTR位置:21只眼CTR位于囊袋内,1只眼CTR部分脱出于囊袋外。IOL位置:22只眼的IOL均位于囊袋内,术后1个月1只眼轻度偏中心,术后2年5只眼轻度偏中心。PCO情况:末次随访3只眼(13.6%)因重度PCO行掺钇钕石榴石激光后囊膜切开,余19只眼为轻度PCO,无需处理。晶状体囊袋收缩程度:末次随访1只眼囊袋中度收缩。Pantacam检查术后1、6、12和24个月IOL的平均偏心值分别为(0.393±0.094)、(0.406±0.094)、(0.415±0.093)、(0.463±0.172)mm,术后1、6与24个月比较,差异有统计学意义(P〈0.05)。倾斜度分别为2.637°±0.369°、2.653°±0.349°、2.682°±0.348°、2.714°±0.360°,各组间差异无统计学意义(P=0.220)。结论CTR合并IOL植入治疗晶状体悬韧带异常可获得良好视力。术后2年的随访观察证实CTR的植入抑制了PCO和囊袋收缩的发生,并维持IOL在囊袋内位置的良好稳定性。(中华眼科杂志,2007.43:519-524)  相似文献   

8.
PURPOSE: To report the pathological findings in 14 human cadaver eyes implanted with a single-piece AcrySof(Alcon Laboratories) posterior chamber intraocular lens (IOL). SETTING: David J. Apple, MD Laboratories for Ophthalmic Devices Research, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. Methods: Fourteen human autopsy eyes implanted with a single-piece AcrySof (SA30AL) IOL were evaluated. The eyes were sectioned at the equatorial plane, and the anterior segment containing the IOL in the capsular bag was evaluated from a posterior perspective (Miyake-Apple view) and from an anterior perspective (surgeon's view) after removal of cornea and iris. They were then processed through paraffin, sectioned, and stained with hematoxylin-eosin, periodic acid-Schiff, and Masson's trichrome and examined under light microscopy. RESULTS: All IOLs had symmetric in-the-bag fixation. Slight decentration was measured in 1 eye, which also had an anterior capsule tear. Grade 1 anterior capsule opacification was present in 9 eyes. No central posterior capsule opacification or posterior capsule folds were observed in any eye. Soemmering's ring formation was observed in 5 eyes. Zonular stretch caused by different degrees of capsular bag contraction was present in 4 eyes without decentration of the IOL. CONCLUSIONS: Analyses of pseudophakic cadaver eyes from the posterior (Miyake-Apple) view, complemented by microscopic analyses, proved useful in the evaluation of IOL-capsular bag interaction. These studies are more important in cases of newly introduced lens designs.  相似文献   

9.
目的 观察Akreos Adapt亲水性丙烯酸酯折叠式人工晶状体(IOL)十字形袋/沟固定法植入在外伤后或白内障术中出现的后囊大破孔时应用的临床效果.方法 对31例(31眼)后囊大破孔者采用十字形袋/沟固定法植入Akreos Adapt亲水性丙烯酸酯折叠式IOL.随访期内观察其术后视力及视觉症状、术后炎症反应、IOL位置及固定状态、囊膜混浊程度、瞳孔和眼压等情况.结果 术后所有眼视力均较术前提高,最佳矫正视力0.1~0.2者4眼,0.3~0.4者5眼,≥0.5者22眼.所有术眼的IOL均在位,基本居中、无移位,视轴透明,未见严重的术后炎症反应或IOL相关并发症,瞳孔及眼压正常.结论 在后囊大破孔但连续环形撕囊完整时可采用十字形袋/沟固定法植入Akreos Adapt亲水性丙烯酸酯折叠式IOL,该法简便、快捷、安全,植入后IOL位置稳定居中,并有良好的生物相容性和眼内稳定性.  相似文献   

10.
Optimal fixation and position of an intraocular lens (IOL) is achieved when it is located in the capsular bag. A peripheral tear from the central opening to the lens periphery is associated with a high incidence of dislocation of at least one loop from within the capsular bag and lens decentration. A central round continuous capsulectomy (capsulorhexis), within the zonule-free area, provides long-term and balanced IOL fixation. To perform a well-controlled capsulectomy, a deep and stable anterior chamber should be maintained throughout the surgery. This is achieved by using a continuous anterior chamber maintainer that regulates the pressure in the anterior chamber. This paper reviews the clinical anatomical guidelines of the lens capsule and the anterior chamber and presents the authors' preferred technique for optimal anterior capsulectomy.  相似文献   

设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号