虹膜夹型人工晶状体矫正高度近视的前节OCT检查分析

目的:使用前节OCT分析高度近视植入虹膜夹型人工晶状体后眼内的结构变化。方法:植入前房晶状体矫正高度近视6眼(11.5D至22.0D),使用前节OCT采集前节图像测量术前前房深度,术后人工晶状体与角膜内皮间距离(内皮—晶状体距离),人工晶状体与正常晶状体间距离。结果:术前前房深度为3.27～3.91mm,术后内皮—晶状体距离为2.07～2.24mm。人工晶状体后表面与正常晶状体间的距离为0.82～1.32mm。图像显示虹膜色素层没有明显改变。结论:前房深度较术前减少36.1%～44.6%。前节OCT对于检测虹膜夹型前房晶状体的位置有帮助。     

Ultrasound Biomicroscopy of Iris-claw Phakic Intraocular Lens Implantation

Purpose: To study in situ the intraocular position of iris-claw phakic intraocular lens (ICPIOL) in myopic eyes using ultrasound biomicroscopy (UBM). Methods: UBM echograms of the anterior segment were taken preoperatively and 62 to 115 days postoperatively in 6 eyes implanted with the Verisys ICPIOL (AMO). The echograms were assessed for the effect of the ICPIOL on iris tissue. Results: The preoperative distance between the corneal endothelium and the lens ranged from 2.96 to 3.09 mm, and the postoperative distance between the ICPIOL and the corneal endothelium, from 1.86 to 2.03 mm. The distance between the lens and the posterior surface of the ICPIOL ranged from 0.61 to 0.76 mm. The distance between the superior, inferior optic edge and the iris ranged from 0.49 to 1.00 mm, 0.21 to 0.51 mm respectively. The shortest distance between the ICPIOL haptics and the angle of anterior chamber ranged from 1.25 to 1.65 mm. The indentation of iris tissue by the ICPIOL haptics without pigmentary dispersion and distortion of posterior curvature of iris was observed. Conclusion : Adequate space is maintained between the Verisyse myopic ICPIOL and the corneal endothelium, angle, and crystalline lens. Haptic indentation of the iris without pigment erosion and distortion of iris curvature is noted. The ICPIOL implanted in phakic eyes is a safe alternative for treatment of high myopia.     

Ultrasound biomicroscopy of the Artisan phakic intraocular lens in hyperopic eyes

PURPOSE: To study in situ the intraocular position of the Artisan iris-claw intraocular lens (IOL) (model 203) (Ophtec) in phakic hyperopic eyes using ultrasound biomicroscopy (UBM). METHODS: Echograms of the anterior chamber were taken preoperatively and 24 to 317 days postoperatively in 4 eyes implanted with the Artisan IOL (power +4.0 to +6.0 diopters). The preoperative anterior chamber depth (ACD) and the postoperative distance between the IOL and the corneal endothelium (endothelium-optic distance) and between the IOL and the lens were measured. The echograms were assessed for the effect of the IOL on iris tissue. RESULTS: The preoperative ACD ranged from 3.10 to 3.56 mm and the postoperative endothelium-optic distance, from 2.03 to 2.54 mm. The distance between the lens and the posterior surface of the IOL ranged from 0.35 to 0.79 mm. Several UBM echograms showed indentation of iris tissue by the IOL haptics and optic edge, although no pigmentary dispersion was noted. CONCLUSIONS: Adequate space was maintained between the Artisan hyperopic IOL and the corneal endothelium, angle, and crystalline lens. Haptic indentation of the iris, which could lead to pigment erosion, was observed. Preoperative gonioscopy and maintenance of normal intraocular pressure postoperatively suggest the indentation was secondary to inadequate lens vaulting relative to the high natural arch of the iris in hyperopic eyes. Shortening the haptics or increasing the lens vault might resolve this problem.     

应用Pentacam三维眼前段分析仪对虹膜夹型人工晶状体植入术后的研究

目的 应用Pentacam术后追踪测量虹膜夹型有晶状体眼人工晶状体(PIOL)中央和周边部与角膜内皮和自然晶体之间的距离,倾斜度、偏心值以及前房深度的变化,评价其在前房的位置.方法 收集自2006年1月以来接受虹膜夹型人晶状体植入术的22例33只眼.术后6个月全部患者行Pentacam检查,测量VRSM50和VRSM60两组不同类型虹膜夹型PIOL中央和周边部与角膜内皮和自然晶体之间的距离,并测量术后1d、1、3及6个月人工晶状体的偏心量、倾斜度及前房深度值.结果 角膜内皮至PIOL光学部前表面距离为(1.94±0.36)mm.PIOL后表面与自然晶状体间的距离为(0.76±0.12)mm.分别比较各组在不同时期的平均偏心量与平均倾斜度,差异无统计学意义(P>0.05).在术后1d、1、3及6个月,比较2组的平均偏心量与平均倾斜度,差异无统计学意义(P>0.05).结论 Pentacam三维眼前段分析仪为PIOL植入术后提供高质量的Scheimpflug摄像,可以为有晶状体眼前房型人工晶状体提供精确的眼内定位,在这一方面具有重要的临床应用价值.     

Scheimpflug biometry of the anterior segment after implantation of foldable iris-fixated lenses

PURPOSE: To evaluate intraocular dimensions of the anterior segment of myopic phakic eyes after implantation of foldable iris-fixated lenses. METHODS: Seventeen myopic eyes that received a foldable iris-fixated phakic intraocular lens (PIOL) were assessed. Distances between the cornea and the IOL-optic edge and between the IOL optic and the crystalline lens were evaluated using Scheimpflug photography 3 months postoperatively. RESULTS: The average postoperative distance between the central corneal endothelium and the anterior surface of the IOL was 2.01 +/- 0.26 mm. The distance between the corneal endothelium and the peripheral edge of the IOL averaged 1.32 +/- 0.18 mm at the 12 o'clock position and 1.34 +/- 0.21 mm at the 6 o'clock position. The distance between the crystalline lens and the posterior surface of the IOL averaged 0.73 +/- 0.09 mm. CONCLUSIONS: The high quality of the three-dimensional Scheimpflug images allowed measurements of intraocular distances in PIOL implanted eyes. Distances between the foldable iris-fixated IOL and crucial surrounding tissues could be determined 3 months postoperatively.     

Position of myopic iris-claw phakic intraocular lens by Scheimpflug photography and ultrasound biomicroscopy

PURPOSE: To evaluate the position of iris-claw phakic intraocular lens (ICPIOL) in highly myopic eyes by Scheimpflug photography (SP) and ultrasound biomicroscopy (UBM). METHODS: Nine eyes of five patients aged 31+/-10 years with average spherical equivalent of -16.04+/-5.46 D (range -7.88 to - 22.88 D) were enrolled in this prospective study and implanted with Verisyse ICPIOLs (AMO). The anterior segment was evaluated by SP and UBM preoperatively and for at least 1 month postoperatively. The statistical significance may be questionable due to the limited number (nine) of eyes. RESULTS: By SP and UBM, the distance between corneal endothelium and lens (anterior chamber depth) preoperatively was 3.10+/-0.14 and 3.07+/-0.11 mm, respectively; between ICPIOL and corneal endothelium (pseudo-anterior chamber depth), 1.88+/-0.09 and 1.99+/-0.12 mm, respectively; between lens and posterior surface of ICPIOL (IL), 0.76+/-0.13 and 0.67+/-0.06 mm, respectively; between superior optic edge and iris (SOEI), 0.23+/-0.23 and 0.58+/-0.24 mm, respectively; between inferior optic edge and iris (IOEI), 0.07+/-0.13 and 0.41+/-0.22 mm, respectively; between ICPIOL haptics and the angle of anterior chamber (HA), 0.90+/-0.17 and 1.45+/-0.13 mm, respectively. ACD was well correlated between the two methods, but PACD, IL, OEI, HA were not. The postoperative measures, except IL, were significantly different between the two methods. CONCLUSION: The differences between measurements by SP and UBM reveal the ICPIOL's position variations with change of body position. Nevertheless, it seems adequate that space is maintained between ICPIOL and corneal endothelium, angle, and crystalline lens. The ICPIOL implanted in phakic eyes seems a safe alternative for treatment of high myopia.     

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。     

Ultrasound biomicroscopy of ZSAL-4 anterior chamber phakic intraocular lens for high myopia.

PURPOSE: To evaluate the intraocular location and anatomic relationship to other structures of the ZSAL-4 angle-supported anterior chamber phakic intraocular lens (IOL) for high myopia using ultrasound biomicroscopy (UBM). SETTING: Clínica de Nuestra Se?ora de la Concepción, Fundación Jiménez Díaz, and Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Madrid, Spain. METHODS: Eight phakic myopic eyes corrected by ZSAL-4 angle-supported anterior chamber phakic IOLs were examined by UBM. The distance between the corneal endothelium and the IOL at the central and peripheral cornea and between the phakic IOL and the iris was measured. RESULTS: The mean distance between the central cornea and the IOL was 2361.37 microm +/- 109.62 (SD); between the edge of the IOL optic and the endothelium, 1646.24 +/- 27.06 microm; and between the IOL and the iris, 354.46 +/- 41.61 microm. The IOL footplates appeared to be correctly positioned in the anterior chamber angle in all eyes. CONCLUSION: The space between the IOL and the endothelium was greater in eyes with the ZSAL-4 angle-supported phakic IOL than in eyes with other angle-supported phakic IOLs. The possibility of intermittent contact between the IOL edge and the midperipheral cornea plays a minor role in the mechanism of endothelial damage with this lens model.     

Position of angle-supported, iris-fixated, and ciliary sulcus-implanted myopic phakic intraocular lenses evaluated by Scheimpflug photography

PURPOSE: To examine postoperative positional stability of myopic phakic intraocular lenses (IOLs). DESIGN: Prospective, nonrandomized clinical study. METHODS: The study included 46 eyes which received an anterior chamber angle-supported (Bausch & Lomb NuVita; 10 eyes), anterior chamber iris-fixated (Ophtec Artisan; 20 eyes) or ciliary sulcus-implanted phakic IOL (Staar ICL; 16 eyes). The distance between the phakic IOL and the crystalline lens and the cornea as well as rotation around the optical axis was evaluated using Scheimpflug photography at 1, 3 to 6, and 12 months postsurgery. RESULTS: The anterior chamber phakic IOLs showed no significant movement in anteroposterior direction. The posterior chamber phakic IOL showed a significant movement toward the crystalline lens between postoperative months 3 and 12. The median amount of rotation around the optical axis between the 3- and the 12-month evaluation was 1.9 degrees (range = 0.0-33.5 degrees) for the NuVita, 0.6 degrees (range = 0.0-3.5 degrees) for the Artisan, and 0.9 degrees (range = 0.2-2.3 degrees) for the ICL. Four NuVita IOLs rotated more than 10 degrees. CONCLUSIONS: The angle-supported anterior chamber phakic IOLs showed a generally stable position regarding distance to cornea and natural lens, but rotation was observed in four IOLs. The iris-fixated phakic IOL showed the highest overall stability. The posterior chamber phakic IOL was stable in terms of rotation but had a tendency to decrease in distance toward the crystalline lens. Intraocular lenses implanted in phakic eyes followed for 12 months demonstrate stable IOL position overall.     

Correlation between quantity of silicone oil emulsified in the anterior chamber and high pressure in vitrectomized eyes

PURPOSE: To assess the existence of any correlation between the quantity of silicone oil emulsified in the anterior chamber and the incidence of high intraocular pressure in vitrectomized eyes. METHODS: Forty-nine eyes of 49 patients underwent vitrectomy with silicone oil injection as an adjuvant procedure. At the time of observation, between September 1999 and September 2000, 13 eyes (26.5%) were phakic; 23 eyes (47%) were pseudophakic; and 13 eyes (26.5%) were aphakic. Ultrasound biomicroscopy, slit-lamp biomicroscopy, and gonioscopy were performed to quantify the presence of silicone oil emulsified in the anterior chamber. RESULTS: The 13 phakic eyes did not have a high intraocular pressure. In 8 of the 13 eyes, ultrasound biomicroscopy detected only scarce oil emulsification in the anterior chamber (0.304 mm); in 5 of the 13 eyes, gonioscopy and ultrasound biomicroscopy did not detect anterior chamber oil emulsification. Fourteen of 23 pseudophakic eyes had a high intraocular pressure; of these, ultrasound biomicroscopy detected an abundant amount of anterior chamber oil emulsification (0.922 mm). Nine of 23 pseudophakic eyes did not have a high intraocular pressure; of these, ultrasound biomicroscopy detected little anterior chamber oil emulsification (0.209 mm). The 13 aphakic eyes had a high intraocular pressure; of these, ultrasound biomicroscopy detected an abundant amount of anterior chamber oil emulsification (0.795 mm). The coefficient of correlation for the measurements obtained was 0.98 (F = 62.3, P = 0.05; t = 11.1, P = 0.001). CONCLUSION: This study showed a high correlation between the incidence of high intraocular pressure and the quantity of emulsified silicone oil in the anterior chamber.     

Visian Collamer phakic intraocular lens in high myopic Asian eyes

PURPOSE: To evaluate the safety and efficacy of the Implantable Collamer Lens (Visian), a phakic intraocular lens (PIOL), in the correction of high myopia in Asian eyes. METHODS: This prospective study comprised 61 eyes in 40 Chinese patients with mean preoperative manifest spherical equivalent refraction of -14.54 +/- 3.61 diopters (D) (range: -7.00 to -24.75 D) who underwent Visian PIOL implantation from May 2002 to December 2004. The anatomical differences between Asian and Caucasian eyes were compared. RESULTS: Mean follow-up was 13.67 +/- 8.51 months (range: 1 to 32 months). Predictability of the manifest spherical equivalent refraction to within +/- 1.00 D was achieved in 88% of eyes and +/- 0.50 D in 72.5% of eyes. The mean postoperative manifest spherical equivalent refraction was -0.10 +/- 0.74 D, with 97% of eyes maintaining or gaining > or = 1 lines of best spectacle-corrected visual acuity (BSCVA). Two eyes lost 1 line of BSCVA. Retinal detachment developed in 1 eye 15 months after initial surgery. Because of the statistical differences in anterior chamber depth and white-to-white distance between Caucasian and Chinese eyes, the Visian PIOL size was more accurate if the calculation was modified so that 0.5 mm was added to the white-to-white measurement if the anterior chamber depth was < or = 3.0 mm and 1.0 mm to the white-to-white measurement if the anterior chamber depth was >3.0 mm. Initial incorrect sizing using the original nomogram led to the only cataract in our series. CONCLUSIONS: The implantation of the Visian PIOL for correcting moderate to high myopia in Asian eyes shows similar safety and efficacy to the FDA clinical trial of Caucasian eyes. Proper sizing of the Visian PIOL is important and differs slightly in Asian eyes.     

全景超声生物显微镜对人眼睫状沟距离及前房直径的测量

背景睫状沟距离的直接测量对人工晶状体（IOL）植人术中IOL尺寸的选择具有重要意义。全景超声生物显微镜（UBM）的问世使在活体眼直接进行睫状沟距离的测量成为可能。目的探讨人眼前房直径和睫状沟距离之间的相关性及其在不同前房深度人群中的差别。方法将疑似青光眼患者30例30只右眼作为浅前房组,而具有高度近视（-7— -18D）的30例30只右眼作为深前房组。应用全景超声生物显微镜（UBM）进行图像采集,每眼获取焦点位于虹膜平面的眼球水平方向3：00～9：00处的全景截面图像共3张。由同一测量者对每一幅图像的前房直径和睫状沟距离进行测量。取3幅图像测量值的均值为最终测量结果,用独立样本t检验和线性回归方程分析评估前房直径与睫状沟距离测量值的关系。结果浅前房组的30眼中,全景UBM测得的前房直径为（11．49±0．75）mm,睫状沟距离为（10．97±0．86）mm,二者间的平均差值为（-5．14±0．55）mm,差异有统计学意义（t=-5．092,P=0．000）,线性回归分析显示二者之间呈线性相关（R2=0．593,P=0．000）,Pearson相关系数为0．767。深前房组的30眼中,全景UBM测得的前房直径均值为（12．69±0．67）mm;睫状沟距离为（12．31±0．61）mm,二者之间平均差值为（-0．38±0．17）mm,差异有统计学意义（t=-5．531,P=0．000）;线性回归分析显示二者之间具有显著相关性（R2=0．699,P=0．000）,Pearson相关系数为0．836。结论全景UBM测得的睫状沟距离和前房直径呈明显正相关,深前房眼的相关性大于浅前房眼,该结果对于IOL植入术中IOL尺寸的选择具有重要意义。     

Intraoperative autorefraction for combined phakic intraocular lens explantation and cataract surgery

PURPOSE: To evaluate intraoperative autorefraction during combined phakic intraocular lens (PIOL) explantation and cataract surgery. METHODS: Phakic intraocular lens explantation was followed by crystalline lens emulsification and reformation of the anterior chamber with balanced salt solution. Autorefraction was performed intraoperatively with the Nikon Retinomax 2, and the IOL power was calculated using a formula for myopic eyes: IOL for emmetropia = 1.3 x aphakic spherical equivalent refraction + 1.45. RESULTS: Nineteen myopic eyes of 15 patients with anterior or posterior chamber PIOL (including 6 eyes that had undergone photorefractive keratectomy) were treated. Two months postoperatively, mean spherical equivalent refraction was -0.56+/-0.40 diopters (D) (range: 0 to -1.50 D). CONCLUSIONS: In myopic eyes, intraoperative auto-refraction provided a simple and reliable method to calculate IOL power in combined PIOL explantation and cataract surgery.     

有晶状体眼前房虹膜夹持型人工晶状体植入治疗高度近视

目的：观察有晶状体眼前房型虹膜夹持人工晶状体植入治疗高度近视的临床疗效。 方法：对28例50眼高度近视患者进行有晶状体眼Verisyse前房虹膜夹持型人工晶状体植入手术,观察术后的裸眼视力、最佳矫正视力、眼压、角膜及前房内炎症变化情况。 结果：患者28例50眼均顺利在前房内植入虹膜夹持的人工晶状体,术后所有患者视力较术前均增加。术后1a,裸眼视力38眼（76%）≥1.0,12眼（24%）≥0.5,最佳矫正视力40眼（80%）≥1.0,10眼（20%）≥0.5。术后22眼最佳矫正视力均达到并超过术前最佳矫正视力。 结论：高度近视患者有晶状体眼前房植入虹膜夹持型人工晶状体是一种较好的安全有效的矫正视力的方法,术后屈光效果令人满意。     

Ultrasound biomicroscopy in uveitis-glaucoma-hyphema syndrome

PURPOSE: To assess anterior segment anatomy in uveitis-glaucoma- hyphema syndrome. DESIGN: Retrospective case series. METHODS: Nine pseudophakic eyes (nine patients) with complete or incomplete uveitis-glaucoma-hyphema syndrome underwent ultrasound biomicroscopy. RESULTS: Ultrasound biomicroscopy revealed intraocular lens malposition in each case. Of the eight eyes with posterior chamber intraocular lenses, haptics were in contact with the iris pigment epithelium (four eyes) or the pars plicata (three eyes) or prolapsed into the angle recess near a filtration bleb internal ostium (one eye). All other posterior chamber intraocular lens haptics were located in the ciliary sulcus with the exception of two in the capsular bag. Both haptics in the eye with the anterior chamber intraocular lens had eroded into the ciliary body. CONCLUSION: By its ability to detect haptic position, ultrasound biomicroscopy can assist in elucidating the cause of uveitis-glaucoma-hyphema syndrome and in deciding on the course of treatment.     

超声生物显微镜观察弹性开放襻前房型人工晶状体对眼前段结构的影响

目的 评价弹性开放襻一体型前房型人工晶状体（anter chamber intraocular lens,AC-IOL)植入式的疗效及其安全性。方法 应用超声生物显微镜观察20例（20只眼）弹性开放襻一体型AC-IOL植入术后患者IOL襻的位置,以及其与虹膜及房角结构的关系,从而评价IOL对眼前段结构的影响。随访时间6～20个月。结果 40个IOL襻中,26个襻固定于房角隐窝;14个襻（8只眼）穿过虹膜侵入至睫状体实质内,并伴有反复发作的葡萄膜炎。术后8只眼虹膜前粘连与IOL襻有关。结论 超声生物显微镜检查是动态了解IOL对眼前段结构影响的有效方法。AC-IOL襻的设计有待进一步改进。     

Ultrasound biomicroscopy of silicone posterior chamber phakic intraocular lens for myopia

PURPOSE: To study the intraocular position and anatomic relationships of PRL-III (phakic refractive lens) (PRL) posterior chamber phakic intraocular lens (PCP IOL) for high myopia using ultrasound biomicroscopy (UBM). SETTING: Centro Oftalmológico Real Vision, and Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Universidad Complutense de Madrid, Madrid, Spain. METHODS: Sixteen phakic myopic eyes that had had PRL implantation were examined by UBM 1 month after surgery. The PRL position, PRL-crystalline lens peripheral distance, and central distance between the corneal endothelium and the PRL were measured. RESULTS: Both haptics were on the zonule in 6 eyes, in the ciliary sulcus in 5 eyes, and impacted in the ciliary body in 1 eye. In the 4 remaining eyes, the haptics were in mixed positions. The mean PCP IOL crystalline lens peripheral distance in the minor axis was 588.1 microm +/- 232.5 (SD), and the mean PCP IOL-endothelium central distance was 2082.8 +/- 277.6 microm. CONCLUSIONS: Phakic refractive lens implantation should be done carefully because of the sulcus location of the haptics in many cases. This, with the iris-PRL contact, suggests caution for the long-term outcome.     

两种矫正高度近视虹膜夹型人工晶状体植入后眼内稳定评价

目的 评估两种虹膜夹型有晶状体眼人工晶状体(ICPIOL)矫正超高度近视植入后的稳定性和安全性.方法 选取超高度近视患者8例16只眼,依据度数1只眼植入硬性型ICPIOL;另眼植入折叠型ICPIOL.术后随诊3月,使用Pentacam前房分析仪分别评估人工晶状体距离中心角膜和距离自然晶状体之间的距离;使用角膜内皮测量仪,分别测量术前术后角膜内皮细胞记数,以评估其安全性及眼内稳定性.结果 术后3个月裸眼视力6只眼(38%)≧1.0,10只眼(63%)≧0.5.最佳矫正视力7只眼(44%)≧1.0,16只眼(100%)≧0.5.术后15只眼最佳矫正视力均达到并超过术前最佳矫正视力,11只眼(69%)提高视力表两行.角膜内皮至IOL光学部前表面距离为(2.04±0.38)mm.IOL后表面与自然晶状体间的距离为(0.76±0.15)mm.两种ICPIOL相比各组数据差异无统计学意义(P＞0.05).结论 两种ICPIOL术后眼内稳定性好,但还应长期随诊观察.     

Cataract after minor trauma in a young patient with an iris-fixated intraocular lens for high myopia

PURPOSE: To report a case of traumatic cataract in a young patient with an iris-fixated phakic intraocular lens (PIOL). DESIGN: Interventional case report. METHOD: A 32-year-old woman with bilateral iris-fixated PIOLs for high myopia presented with a cortical cataract 2 weeks after minor ocular trauma. Ultrasound biomicroscopy and endothelial cell count were performed before and after cataract surgery. RESULTS: The distance between the PIOL and the crystalline lens was 0.82 mm; the distance between the PIOL and the corneal endothelium was 2.30 mm. Endothelial cell count was 2,500 cells/mm(2) before surgery and 2,476 cells/mm(2) at 1 year follow-up. CONCLUSIONS: Patients with iris-fixated PIOLs are at risk of rapid cataract progression after minor ocular traumatism.     

High-frequency ultrasound biomicroscopy of silicone posterior chamber phakic intraocular lens for hyperopia

PURPOSE: To study the intraocular position and anatomic relationships of the PRL-III phakic refractive lens (PRL), a posterior chamber phakic intraocular lens (PCP IOL), in cases of hyperopia using ultrasound biomicroscopy (UBM). SETTING: Centro Oftalmológico Real Vision, Madrid, Spain, and Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Universidad Complutense, Madrid, Spain. METHODS: Eleven phakic hyperopic eyes of 6 patients who had PRL implantation were examined by UBM 1 month after surgery. The PRL position, PRL-crystalline lens peripheral distance, and central distance between the corneal endothelium and the PRL were measured. RESULTS: Eight eyes had both haptics on the zonule, 2 had 1 haptic in the sulcus and 1 on the zonule, and 1 had 1 haptic in the sulcus and the other in the ciliary body. The mean PCP IOL-crystalline lens peripheral distance in the minor axis was 239.7 microm +/- 179.4 (SD) and the mean PCP IOL-endothelium central distance, 2146.98 +/- 219.6 microm. Contact between the PCP IOL and crystalline lens was observed in 1 eye. CONCLUSIONS: In this study of hyperopic eyes, the PRL was located on the zonule in most cases. However, the location of the haptics in the sulcus and contact between the PCP IOL and the crystalline lens that occurred in some cases suggest further study of possible long-term complications is needed.