有晶状体眼虹膜支撑型人工晶状体的研究进展

有晶状体眼虹膜支撑型人工晶状体（虹膜支撑型PIOL）植入是近年矫正屈光不正的一项新技术，它具有矫正屈光范围广、预测性和稳定性好、可逆性、保留调节功能等优点，虹膜支撑型PIOL植入可矫正高度近视眼、高度远视眼、屈光参差性弱视、穿透性角膜移植术后屈光不正、晶状体摘除联合PIOL植入治疗儿童或成年人晶状体半脱位等，复曲面有晶状体眼人工晶状体（TPIOL）植入可矫正包括2D以上散光的屈光不正。手术并发症包括角膜内皮损伤、白内障、一过性高眼压、眩光和光晕、人工晶状体偏中心或脱位、色素播散等。随着人工晶状体设计的改良和临床经验的积累，手术并发症逐渐减少。虹膜支撑型PIOL植入术初步临床观察显示近期效果满意，远期效果有待进一步观察。     

后房型有晶状体眼人工晶状体外伤性脱位

目的 研究后房型有晶状体眼人工晶状体（PC—PIOL）植入术后外伤致其脱位的临床特点及治疗原则。方法 我院PC-PIOL植人手术矫正高度近视42例（80眼）中2例（2眼）因眼外伤导致PC-PIOL脱位。1眼系植入可植入式隐形眼镜（ICL）术后8个月不全脱位于前房;另1眼系植入后房型有晶状体眼屈光晶状体（PC—PRL）术后3个月全脱位于前房。两例分别于外伤后1d、3d接受PC-PIOL的复位手术。比较术前术后角膜内皮细胞计数的不同。2例术后观察均在6个月以上。结果 PC-PIOL脱位于前房患者主觉眼部轻度不适,视力下降。检查可见房水闪光明显,瞳孔变形,人工晶状体被瞳孔夹持。手术复位后视力恢复,遗留瞳孔变形。另1例ICL不全脱位后裸眼视力为0．2,复位术后为0．3。PC-PRL全脱位后裸眼视力为0．3,术后恢复至1．0,术后最佳矫正视力均未下降。2例均未发生白内障等并发症。2例脱位后角膜内皮细胞计数分别为1941／mm^2和1889／mm^2,手术复位后1周角膜内皮计数分别为1883／mm^2和1746／mm^2,手术复位后6个月角膜内皮计数分别为1911／mm^2和1845／mm^2。结论 眼外伤可导致PC-PIOL全脱位或不全脱位于前房,引起前部葡萄膜反应,瞳孔变形,还可导致角膜内皮细胞计数下降。立即手术复位安全有效,但应长期随访角膜内皮细胞计数变化。     

有晶状体眼虹膜固定型人工晶状体植入术后远期人工晶状体脱位临床分析

目的 探讨有晶状体眼虹膜固定型有晶状体眼人工晶状体(phakic intraocular lens,PIOL)植入术后远期人工晶状体脱位、移位情况及原因分析。方法 对我中心2005至2013年开展的Verisyse PIOL植入术矫正高度近视患者52例(104眼)进行术后平均6.5 a随访性研究,对其中发生PIOL脱位、移位患者的临床资料进行回顾性分析。结果 104眼中8眼发生PIOL不全脱位,其中1眼是因为拳头打伤颞侧晶状体袢脱落,2眼因皮球打伤眼睛致一侧晶状体袢脱落,1眼因撞击后出现鼻侧晶状体袢脱落,2眼是搬动重物一侧晶状体袢脱落,1眼是自然分娩后出现双侧晶状体袢脱落并PIOL脱落入前房,1眼是夹持虹膜部位退行性改变致晶状体脱位。7眼发生PIOL下移,下移程度>0.5 mm,其中晶状体袢单侧下移2眼,双侧下移5眼。8眼PIOL脱位中6眼行PIOL再固定术,2眼行PIOL取出术。结论 PIOL脱位与术后眼部外力及外伤、眼压波动、手术时固定虹膜组织的程度不够、所夹取的虹膜组织发生脱色素和退行性变有关,PIOL本身有自身的重量,长期作用会发生向下移位或襻脱离。     

Artisan虹膜夹持型人工晶状体治疗无晶状体眼临床观察

目的观察Artisan虹膜夹持型人工晶状体治疗无晶状体眼的疗效和手术并发症。方法观察2007年3月至2009年3月间在我院住院接受Artisan虹膜夹持型人工晶状体植入术的无晶状体眼患者11例（11只眼）,比较患者手术前后裸眼视力（UCVA）、最佳矫正视力（BCVA）,比较术前术后眼压变化,裂隙灯显微镜观察术后角膜水肿、前房闪辉、晶状体位置,角膜内皮镜检查比较术前术后角膜内皮细胞计数,光学相干断层扫描仪（OCT）观察手术前后黄斑区视网膜厚度。结果患者术后UCVA优于术前BCVA,术前术后眼压无明显变化,术后角膜无明显水肿,晶状体位置未见明显偏移。术后1个月时角膜内皮细胞丢失无统计学意义,黄斑区厚度比术前无明显增加。结论Artisan虹膜夹持型人工晶状体植入术是一种安全有效的治疗无晶状体眼的方法,手术操作相对简单,组织损伤小,并发症少。在虹膜组织足够支撑晶状体时可作为常规术式予以考虑。     

Artisan虹膜夹持型人工晶状体植入治疗马凡综合征晶状体半脱位

目的探讨Artisan 虹膜夹持型人工晶状体（IOL）植入术治疗马凡综合征晶状体半脱位的有效性和安全性。方法 回顾性病例研究。2007年12月至2011年7月在广东省人民医院眼科确诊的马凡综合征晶状体半脱位患者16例（25眼）,行连续环形撕囊后,完成晶状体吸除、晶状体囊膜切除、前段玻璃体切割、Artisan IOL前房虹膜夹持固定和虹膜周边切除术。比较手术前后裸眼视力（UCVA）、最佳矫正视力（BCVA）、眼压、角膜内皮细胞计数,记录术后虹膜夹持型IOL位置、角膜内皮细胞丢失率,术中、术后并发症情况。随访时间6个月。采用非参数检验（Wilcoxon 检验）对手术前后UCVA和BCVA进行比较。结果 术后6个月UCVA和BCVA均较术前明显提高,术前和术后6个月UCVA（logMAR）分别为1.05±0.26和0.46±0.29,两者相比差异有统计学意义（Z=-4.530,P<0.01）。术前和术后6个月BCVA（logMAR）分别为0.68±0.32和0.27±0.22,两者相比差异具有统计学意义（Z=-2.208,P<0.01）。术后所有患眼虹膜夹持型IOL位置居中,单眼复视症状消失。术后2眼出现一过性高眼压,1眼出现脉络膜脱离,1眼出现视网膜脱离,未发生IOL移位、角膜失代偿等严重并发症。术后6个月平均角膜内皮细胞丢失率为5.6%。结论 Artisan虹膜夹持型IOL植入治疗晶状体严重脱位可提高视力,消除单眼复视且安全有效。     

有晶状体眼前房型人工晶状体植入治疗高度近视疗效观察

目的 观察有晶状体眼前房型虹膜固定人工晶状体植入治疗高度近视的临床疗效.方法 对11例(17只眼)高度近视患者进行术前虹膜YAG激光周边切除,1周后接受有晶状体眼Verisyse前房虹膜固定型人工晶状体植入手术,观察术后的裸眼视力、最好矫正视力、眼压、角膜及前房内炎症变化情况.结果 11例(17只眼)均顺利在前房内植入虹膜固定的人工晶状体,其中1只眼术后第3天发现人工晶状体单侧脱位再次手术固定.术后所有患者视力较术前均增加,裸眼≤0.5者3只眼,>0.5者14只眼.16只眼眼压术后检查正常,1只眼术后眼压升高至25 mm Hg,局部加用0.5%噻吗心胺点眼,2 d后眼压恢复正常.术后所有患者角膜透明,无内皮水肿的情况.13只眼出现前房轻度闪辉,4只眼前房可见较多的炎性细胞,用药后很快控制.结论 高度近视患者有晶状体眼前房植入虹膜固定型人工晶状体是一种较好的矫正视力方法,但其远期疗效及并发症有待进一步观察.     

有晶状体眼悬浮型后房型人工晶状体植入治疗高度近视

目的观察和探讨悬浮型后房型有晶状体眼人工晶状体（PC-PRL）植入术治疗高度近视的效果及安全性。方法回顾性病例研究。38例（68眼）高度近视患者（近视度为-11.25～-20.00 D）植入PC-PRL。术前及术后1周、1个月、3个月、6个月对患者的视力、眼压、角膜内皮细胞计数、前房深度及PC-PRL位置进行观察。采用重复测量方差分析比较PIOL术后不同时间段的等效球镜的差异。结果术后6个月时,所有患者UCVA均≥4.7,达到或高于术前BCVA（F=6.813,P<0.01）;术后7例（10眼）早期眼压升高,经降眼压治疗后眼压正常;术后前房深度较术前有所下降（F=32.952,P＜0.01）,小梁虹膜水平/垂直夹角、房角开放距离、拱高均无明显变化（P＞0.05）,未见虹膜膨隆,房角阻滞;术后PIOL位置稳定,与晶状体距离稳定。结论PC-PRL植入术治疗高度近视效果确切,预测性好,手术安全。     

虹膜夹持型人工晶状体植入术的临床研究

目的：观察Artisan虹膜夹持型人工晶状体植入术治疗无晶状体眼、晶状体脱位及晶状体后囊膜破裂患者的临床疗效。方法回顾性分析甘肃省中医院眼科2010年1月至2011年3月间接受Artisan虹膜夹持型人工晶状体植入术的15例（15只眼）无晶状体眼患者临床资料,比较患者手术前后裸眼视力和最佳矫正视力,比较术前与术后1 d、1周、1个月、3个月、6个月及12个月的眼压和角膜内皮细胞计数变化,裂隙灯显微镜观察术后角膜水肿、前房闪辉及人工晶状体位置。手术前后患者最佳矫正视力的比较采用Wilcoxon符号秩和检验;手术前后患者眼压及角膜内皮细胞计数的比较采用配对 t 检验,其中角膜内皮细胞数量的变化分析采用多元线性回归法建立拟合方程。结果术后1d患者视力显著提高,术后1周较术后1d略有改善,术后1个月后趋于稳定。术前裸眼视力≤0．2,中位数为0．04;术后1个月裸眼视力为0．3～1．2,中位数为0．8,其中裸眼视力≥1．0者4只眼（26．7％）,裸眼视力≥0．5者11只眼（73．3％）。术前最佳矫正视力为0．3～1．0,中位数为0．6;术后1个月最佳矫正视力为0．3～1．2,中位数为0．9,其中最佳矫正视力≥1．0者4只眼（26．7％）,最佳矫正视力≥0．5者13只眼（86．7％）。术后15只眼的最佳矫正视力均达到并超过术前最佳矫正视力,且术后视力保持稳定。术后裸眼视力与术前比较,差异有统计学意义（ W＝3．410, P＜0．05）,术后最佳矫正视力与术前比较,差异有统计学意义（W＝3．035,P＜0．05）。术前角膜内皮细胞计数为932～3325个/mm2,术后1 d角膜内皮细胞计数平均（2224．3±746．1）个/mm2,术后1周角膜内皮细胞计数平均（2214．9±742．1）个/mm2,术后1个月角膜内皮细胞计数平均（2202．4±743．9）个/mm2,术后3个月角膜内皮细胞计数平均（2164．9±724．4）个/mm2,术后6个月角膜内皮细胞计数平均（2138±715．3）个/mm2,术后12个月角膜内皮细胞计数平均（2123．6±712．3）个/mm2。术后各时段角膜内皮细胞计数均值与术前比较,差异有统计学意义（t＝-2．41,-2．76,-3．27,-3．00,-3．52,-3．11;P＜0．05）。术后角膜无明显水肿,人工晶状体位置未见明显偏移。结论 Artisan虹膜夹持型人工晶状体植入术是治疗无晶状体眼、晶状体脱位及晶状体后囊膜破裂患者的既安全又有效的方法,手术操作相对简单,组织损伤小,并发症少。     

虹膜后固定虹膜夹持型人工晶状体在无晶状体眼中的应用

目的 观察虹膜后固定植入的ARTISAN虹膜夹持型人工晶状体在无晶状体眼中的临床应用效果.方法 回顾性分析2010年1月至2011年4月间,在16例16只眼无后囊膜支持的无晶状体眼患者中,通过虹膜后同定植入ARTISAN虹膜夹持型人工晶状体,观察其术后视力、角膜内皮细胞密度、眼压等的变化.结果 16例患者术前最佳矫正视力为0.46±0.19,术后裸眼视力为0.50±0.20,差异有统计学意义(P＜0.05).16例患者术前角膜内皮细胞密度计数为(1914±151)个/mm2,术后1年为(1835±145)个/mm2,平均角膜内皮细胞丢失率4.1％.眼压未见明显改变.l例患者出现眩光不适症状.未见人工晶状体脱位等其他并发症.结论 虹膜后固定虹膜夹持型人工晶状体的手术方式简单,术后视觉质量恢复好,并发症少,是目前治疗无后囊膜支持的无晶状体眼比较好的治疗方法.     

虹膜固定型人工晶状体二期植入治疗无晶状体眼的疗效

目的评价二期植入虹膜固定型人工晶状体治疗各种原因导致的无晶状体眼的疗效。方法选取无晶状体眼患者15例(16眼),均植入虹膜固定型人工晶状体,术后观察患者视力、眼压、角膜内皮细胞计数及并发症情况。结果 15例均一次性成功植入虹膜固定型人工晶状体,显微镜观察人工晶状体位于瞳孔中央。术后裸眼视力0.02-0.80,平均0.35,与术前裸眼视力(手动-0.12)比较差异有统计学意义(P<0.001),与术前矫正视力比较差异无统计学意义(P>0.05)。术后6个月角膜内皮细胞平均丢失率为9.87%。仅1例术后发生瞳孔区玻璃体阻滞。手术前后眼压差异无统计学意义(P>0.05)。结论实施虹膜固定型人工晶状体二期植入术治疗无晶状体眼,能够安全、有效地提高患者的术后视力,但人工晶状体对角膜内皮、虹膜等组织的长期影响还需进一步观察。     

Implantation of verisyse phakic intraocular lens to correct myopic refractive error after penetrating keratoplasty in pseudophakic eyes

PURPOSE: We report 2 cases in which a Verisyse phakic intraocular lens (PIOL) was used to successfully treat high myopia after penetrating keratoplasty (PK) in pseudophakic patients. METHODS: Case 1 involved a 69-year-old pseudophakic man with a manifest refraction (MR) of -6.50 + 1.75 x 048 and a best spectacle corrected visual acuity (BSCVA) of 20/40 approximately 16 months after PK in the right eye. Case 2 was a 78-year-old pseudophakic man who had an MR of -9.00 + 5.75 x 132 with a BSCVA of 20/100 approximately 24 months after PK in the left eye. RESULTS: In case 1, 10 months after Verisyse PIOL implantation, the MR was pl +2.00 x 135 with a BSCVA of 20/30. Endothelial cell density (ECD) in this patient decreased from 1926.1 to 815.3 cells/mm over 17 months. In case 2, 24 months after Verisyse PIOL implantation, the MR was -3.25 + 3.50 x 105 with a BSCVA of 20/60. ECD in this patient decreased from 2108.4 to 753.8 cells/mm in 30 months. CONCLUSION: The Verisyse PIOL may provide an alternative method to correct high myopia for anisometropia in pseudophakic patients after PK. In this report, PIOL implantation was associated with a decrease in ECD. Further studies are required to determine the long-term effects and ultimate safety of PIOL placement on the integrity of the cornea endothelium after corneal transplant in pseudophakic patients.     

前房型虹膜夹人工晶状体植入术治疗无足够囊膜支撑的无晶状体眼的疗效和安全性

目的 探讨前房型虹膜夹人工晶状体植入术治疗无足够囊膜支撑的无晶状体眼的疗效和安全性。方法 选择河北省眼科医院白内障科2013年1月至2020年12月行晶状体摘出一期或二期植入前房型虹膜夹人工晶状体的患者53例62眼作为研究对象,62眼患者均为无足够囊膜支撑的无晶状体眼。术后随访3～9(5.68±1.29)年,收集患者手术前和末次随访裸眼视力(UCVA)、等效球镜度、眼压、前房深度、人工晶状体眼内固定位置及稳定性、角膜内皮细胞密度(ECD)、术后并发症等指标和临床信息。评价前房型虹膜夹人工晶状体植入术治疗无足够囊膜支撑的无晶状体眼的疗效和安全性。结果 术前62眼UCVA(logMAR)为1.55±0.56,术后为0.23±0.15,术后UCVA较术前显著提高(t=18.64,P=0.00)。术后和末次随访UCVA (logMAR)(0.22±0.14)比较,差异无统计学意义(t=1.43,P=0.16),患者术后视力保持稳定。术后末次随访1眼等效球镜度为-1.25 D(为根据另一眼预留),等效球镜度-1.00～<-0.50 D者10眼,-0.50～+0.50 D者51眼。62眼术前...     

虹膜夹型与后房型人工晶状体植入矫正高度近视的远期疗效比较

背景 随着屈光手术的不断进步,有晶状体眼人工晶状体(PIOL)植入术矫正高度近视逐步体现出其独有的优越性,目前评价其短期疗效和安全性的研究较多,但其远期安全性、有效性在临床上越来越受到关注. 目的 观察和比较Verisyse PIOL和可植入眼内接触镜(ICL)植入术矫正高度近视的远期效果、安全性及可预测性.方法 对2009-2011年行PIOL植入术矫正高度近视的患者资料进行回顾性分析,其中Verisyse PIOL植入术9例18眼(Verisyse组)和ICL植入术11例22眼(ICL组),各组术眼术前裸眼视力(UCVA)、最佳矫正视力(BCVA)、眼轴、眼压、角膜内皮细胞密度(ECD)等基线特征匹配.所有手术均由同一医师完成,随访期2年,评价指标包括术眼UCVA、BCVA、等效球镜度(SE)、眼轴、眼压、ECD、对比敏感度(CS)、波前像差及并发症,比较2种手术的安全性、有效性及可预测性. 结果 术后2年,2个组间术眼UCVA、BCVA、SE的差异均无统计学意义(t=0.92、1.32、4.32,均P＞0.05).Verisyse组术眼无眩光状态下不同空间频率CS值均低于ICL组,但差异均无统计学意义(Z=0.782、0.956、0.495、0.874、0.293,均P＞0.05);术后2年Verisyse组术眼眩光状态下不同空间频率CS值均稍低于ICL组,但差异均无统计学意义(Z=0.985、1.254、0.896、1.652、0.492,均P＞0.05).Verisyse组总高阶像差均方根值、垂直三叶草差、垂直慧差、水平慧差和球差均高于ICL组,差异均有统计学意义(Z=4.72、4.24、3.12、3.65、2.16,均P＜0.05).Verisyse组术眼平均有效性指数为108.49±16.62,ICL组为106.71±15.88,组间差异无统计学意义(t=0.54,P＞0.05).Verisyse组平均安全性指数为140.56±33.89,ICL组为143.34±34.56,差异无统计学意义(t=0.29,P＞0.05).Verisyse组术眼可预测性指数为-0.25(-0.97,4.23),低于ICL组的0.98(-1.44,1.52),差异有统计学意义(Z=-2.68,P＜0.05). 结论 Verisyse PIOL和ICL植入术矫正高度近视的有效性、安全性和可预测性均较好,ICL植入术术后术眼的视觉质量和可预测性均优于Verisyse PIOL植入术.     

Traumatic dislocation and successful re-enclavation of an Artisan phakic IOL with analysis of the endothelium

PURPOSE: To present a case of traumatic dislocation of an Ophtec Artisan phakic intraocular lens (PIOL) and an analysis of the endothelial cell count. METHODS: The patient presented with blurred vision in his left eye after sustaining a brow laceration. History included uncomplicated bilateral implantation of an Artisan PIOL to correct myopia. RESULTS: The brow laceration was sutured and topical dexamethasone 0.1% qid was prescribed. One week after presentation, the PIOL was relocated. Postoperatively, endothelial cell count analysis was performed in both eyes. CONCLUSIONS: A decrease in the hexagonality of the endothelial cells was noted in both eyes, which was substantially lower in the injured eye.     

有晶状体眼Verisyse人工晶状体术后视觉质量评估

目的:探讨有晶状体眼人工晶状体术矫正高度近视患者术后的视觉质量。方法:30例高度近视患者(近视屈光度数为-8.25~-21.0D)植入有晶状体眼Verisyse人工晶状体矫正高度近视。术后至少3mo以上进行问卷调查,包括三部分,手术原因问卷,视功能问卷和术后满意度问卷。结果:100%患者均以提高裸眼视力为最主要手术目的,97%是为了去除眼镜,90%以上患者术后视功能好或很好,其中,以中距离视力好或很好的百分比较高。93%患者对该手术表示满意,并愿意推荐给家人或朋友。结论:有晶状体眼人工晶状体植入术矫正高度近视患者术后有较好的视觉质量,术后视功能和满意度均较好。     

【In Press】Complications and outcomes of descemet stripping automated endothelial keratoplasty with Artisan aphakia intraocular lens implantation

AIM: To evaluate the complications and outcomes of descemet stripping automated endothelial keratoplasty (DSAEK) combined with Artisan aphakia intraocular lens (IOL) implantation in severely damaged eyes without capsular support. METHODS: DSAEK combined with Artisan iris claw IOL implantation was performed on 29 eyes. All eyes were of abnormal structure due to complications from prior intraocular surgeries and ocular trauma. Ocular complications observed included graft dislocations, high intraocular pressure (IOP), IOL dislocations, macular edema, and hyphema. Best-corrected visual acuity (BCVA), IOP, and mean central endothelial cell density (ECD) were recorded. RESULTS: Thirteen eyes had a history of ocular trauma, 10 eyes had an anterior chamber IOL, and 16 eyes had prior vitrectomy. The iris was abnormal in 22 cases. Graft dislocation occurred in 5 (17%) of 29 eyes. IOL dislocation occurred in 2 eyes (6.9%). High IOP was found in 9 eyes and was controlled with treatment. The preoperative mean BCVA was 20/286. The 6mo postoperative mean BCVA was 20/42. The average center ECD was 1965.3 cells/mm2 at 6mo, and the rate of the donor cell loss was 34.7%. CONCLUSION: DSAEK combined with Artisan aphakia intraocular lens implantation is an alternative option for resolving endothelial and lens disorders in aphakic eyes without capsular support. However, it should be performed cautiously for eyes with severe iris defects.     

Simultaneous bilensectomy and endothelial keratoplasty for angle-supported phakic intraocular lens-induced corneal decompensation

A 40-year-old lady presented with severe endothelial cell loss in both eyes 14 years after angle-supported phakic intraocular lens (AS PIOL) implantation. The left eye had severe corneal edema with bullous keratopathy. The right eye had markedly reduced endothelial cell count (655 cells/mm 2 ) although the cornea was clear. She underwent simultaneous bilensectomy (AS PIOL explantation and phacoemulsification) and Descemet's stripping and endothelial keratoplasty (DSEK) in the left eye. Explanted AS PIOL was identified as ZSAL-4 (Morcher, Stuttgart, Germany) model. Corneal edema cleared completely in 2 months with a best corrected visual acuity (-2.25 D sph) of 20/60. No intervention was done in the right eye. The present case illustrates that AS PIOL-induced endothelial decompensation can be effectively managed by simultaneous bilensectomy and endothelial keratoplasty.     

Long-term endothelial cell loss after traumatic dislocation and repositioning of Artisan phakic IOL

PURPOSE: To evaluate long-term endothelial cell loss after traumatic dislocation and repositioning of an Artisan phakic intraocular lens (PIOL). METHODS: Traumatic PIOL dislocation occurred in the patient's left eye 4 months after uneventful implantation for unilateral congenital myopia. Using the Konan semi-automated analysis method, endothelial cell density was measured preoperatively, before Artisan repositioning, and 1, 2, and 4 years after primary implantation. RESULTS: Endothelial cell density was 2770 cells/mm2 preoperatively and 2634 cells/mm2 before Artisan repositioning. After successful repositioning, endothelial cell density progressively decreased--1, 2, and 4 years from primary implantation, endothelial cell density was 2582, 2524, and 2538 cells/mm2, respectively, corresponding to losses of 6.8%, 8.9%, and 8.4%, respectively. CONCLUSIONS: Progressive and long-term endothelial loss after traumatic dislocation and repositioning of the Artisan PIOL may be comparable to that reported after uneventful implantation.     

The "sandwich technique" for iris-fixated phakic intraocular lens implantation

PURPOSE: To describe a new technique of implantation of the Artisan/Verisyse phakic intraocular lens (PIOL). METHODS: After PIOL insertion into the anterior chamber, a bolus of a high viscosity ophthalmic viscosurgical device (OVD) is placed over the optic, separating it widely from the endothelium. RESULTS: The technique decreases the chance of endothelial damage during enclavation. CONCLUSIONS: A bolus of a high viscosity OVD placed on the anterior surface of the Artisan/Verisyse PIOL may make enclavation safer.