新型弹性开放襻前房型人工晶体二期植入

目的探讨新型弹性开放襻前房型人工晶体二期植入的效果。方法总计观察３５只眼，其中外伤性白内障术后２８只眼，老年性白内障术后７只眼，距第一次手术时间３个月至２．５年。全部病例随访时间至少６个月。结果３５只眼中，２７只眼（７７．１％）视力恢复至０．５或０．５以上；１１只眼（３１．４％）恢复至１．０或１．０以上。结论新型弹性开放襻前房型人工晶体二期植入安全、有效。     

外伤性白内障后囊破裂人工晶体植入的手术方式选择

目的探讨外伤性白内障晶体后囊不存在时,采用前房型人工晶体植入,抑或后房型人工晶体巩膜缝线固定术。方法外伤性白内障患者８６例（８６只眼）,其中前房型人工晶体（新型弹性开放襻）植入５６例,Ⅰ期植入２９例,Ⅱ期植入２７例;后房型人工晶体巩膜缝线固定（大Ｃ型襻,两根缝线睫状沟固定）３０例,Ⅰ期植入１４例,Ⅱ期植入１６例。结果术后随访１～４２个月。矫正视力≥０．５者,前房型人工晶体组４０例,占７１．４％;缝线固定组２７例,占９０．０％。矫正视力≥１．０者,前房型人工晶体组２２例,占３９．３％;缝线固定组１４例,占４６．７％。结论新型前房型人工晶体植入和后房型人工晶体巩膜缝线固定术均不失为常规后房型人工晶体植入失败的补救措施,但前房型人工晶体适用于年龄较大、眼前段（角膜、虹膜和前房角）条件较好,而眼后段（玻璃体、视网膜）条件较差者;后房型人工晶体巩膜缝线固定术则适用于年龄较小、眼前段条件较差而眼后段条件较好者。     

新型弹性襻前房型人工晶体植入术临床分析

为探讨新型弹性襻前房型人工晶体植入的效果,观察了２３例２４只眼。其中老年性白内障１８眼,外伤性白内障６眼。其中包括１３眼行二期植入术。病例随访时间２个月至２年。结果：２４只眼中,１７眼（７０．８３％）视力恢复至４．５或４．５以上,５眼（２０．８３％）恢复至５．０或５．０以上。结论：新型弹性襻前房型人工晶体植入术操作简单,安全、有效     

弹性开放襻前房型人工晶体一期植入临床报告

目的介绍弹性开放襻前房型人工晶体一期植入方法及疗效观察。方法对18例22只眼自内障术中后囊膜不完整或无后囊膜的无晶体眼，其中老年性白内障8例8只眼，晶体脱位（含白内障）5例9只眼，外伤性白内障5例5只眼同期植入前房型人工晶体，并行虹膜周边切除术。结果随访6～36个月，视力≥0．5者18只眼（81．8％），视力＜0．5者与原发疾病有关。结论弹性开放襻前房型人工晶体一期植入方法简便．疗效安全、可靠。     

弹性开放襻前房型人工晶状体植入术临床观察

目的 观察弹性开放襻前房型人工晶状体植入术的疗效。方法 对32例32只眼白内障术中Ⅰ期或Ⅱ期植入弹性开放襻前房人工晶状体。结果 术后矫正视力＞0.3者29只眼，经长期随访未发现远期并发症。结论 前房型人工晶状体植入操作简便，安全可靠，术后效果好。     

弹性工放襻前房型人工晶体一期植入临床报告

目的 介绍弹性开放襻前房型人工晶体一期植入方法及疗效观察，方法 对１８例２２只眼白内障手术中后囊膜不完整或无后囊膜的无晶体眼，其中老年性白内障８例８只眼，晶体脱位（含白内障）５例９只眼，外伤性白内障５例５只眼同期植入前房型人工晶体，并行虹膜周边切除术，结果 随访６～３６个月，视力≥０．５者１８只眼（８１．８％），视力〈０．５者与原发疾病有关，结论弹性开放襻前房型人工晶体一期植入方法简便，疗效安全，     

新型弹性开襻式前主心型人工晶体植入后房角镜观察

新型弹性开襻式前房型人工晶体（ＡＣ—ＩＯＬ），性能稳定，操作简单，手术损伤轻，尤其适用于后囊缺损、虹膜广泛后粘连者，从而引起人们的关注，应用日趋广泛。但前房型人工晶体对前房角结构的影响尚未见报道，我们对３５只眼行新型弹性开襻式ＡＣ—ＩＯＬ植入术的病例...     

穿透性角膜移植术治疗假晶体大泡性角膜病变的临床观察

目的：评价穿透性角膜移植术治疗假晶体大泡性角膜病变的临床疗效，探讨术中对原人工晶体的处理。方法：假晶体大泡性角膜病变１４例（１４只眼）。原人工晶体类型为后房型人工晶体１２例，弹性开放襻前房型人工晶体２例。手术方法为穿透性角膜移植术１２例，穿透性角膜移植联合人工晶体取出术２例。结果：术后临床症状均完全消失，所有植片均透明，矫正视力０．０２以上１２例（０．１以上４例）。随诊３￣２２个月，１３例植片透明     

外伤性白内障二期前房型人工晶状体植入

目的 探讨外伤性白内障二期植入弹性开放襻前房型人工晶状体的效果和安全性。方法 28例28眼外伤性白内障行二期弹性开放襻前房型人工晶状体植入联合周边虹膜切除术。术后随访3月以上。结果 术后3月裸眼视力≥0．5者20眼(71．4％)，达到术前最佳矫正视力者24眼(85．7％)。术后常见并发症为角膜水肿、葡萄膜炎和眼压升高。结论 外伤性白内障二期植入弹性开放襻前房型人工晶状体是一种简便、安全、有效的方法。     

弹性开放襻前房型人工晶体植入术

弹性开放襻前房型人工晶体植入术徐景美北京铁路总医院眼科（１０００３８）过去前房型人工晶体（ＡＣ—ＩＯＬ）植入后出现了严重并发症而遭到普遍反对。自１９８７年以来，出现了新型弹性开放襻一体型ＰＭＭＡＡＣ—ＩＯＬ，它具有并发症少，操作简便等优点，及ＡＣ—Ｉ...     

Penetrating keratoplasty for pseudophakic bullous keratopathy associated with closed-loop anterior chamber intraocular lenses

Closed-loop anterior chamber intraocular lenses (AC IOLs) are associated with a high incidence of pseudophakic bullous keratopathy (PBK). The prognosis for recovery of vision with penetrating keratoplasty and the exchange of one type of AC IOL for another remains controversial. A total of 40 consecutive patients with closed-loop AC IOLs and varying degrees of PBK underwent penetrating keratoplasty, explanation of the closed-loop AC IOL, and implantation of a flexible tripod AC IOL--all done with a uniform technique. The average follow-up study was 24 months. Average preoperative visual acuity was 20/170 (range, 20/25-hand motions) and average postoperative visual acuity was 20/44 (range, 20/20-no light perception). A total of 23 eyes (57.5%) achieved a visual acuity of 20/40 or better. Eleven eyes (27.5%) had a visual acuity of 20/200 or worse. Persistent cystoid macular edema was the most frequent cause of poor vision postoperatively (4 eyes), followed by age-related macular degeneration (3 eyes) and graft rejection (2 eyes). This is the first series documenting a good visual outcome for at least 2 years after penetrating keratoplasty and exchange of a closed-loop AC IOL for a single type of flexible tripod AC IOL.     

A prospective study on the implantation of anterior chamber intraocular lenses during keratoplasty for pseudophakic and aphakic bullous keratopathy

Between April 1986 and April 1989, the authors conducted a prospective study of the use of open-loop anterior chamber intraocular lenses (AC IOLs) in patients undergoing penetrating keratoplasty for pseudophakic bullous keratopathy or monocular aphakic bullous keratopathy. All patients underwent the same operation--a penetrating keratoplasty combined with insertion of an open-loop AC IOL. Pseudophakic patients had an IOL exchange at the time of surgery. Thirty-six patients have been followed an average of 15 months. Thirty-two (89%) of the grafts are clear. Preoperatively, 100% of eyes had visual acuity less than 20/200. Postoperatively, 11 eyes (31%) have visual acuity better than 20/40 and 23 eyes (64%) have visual acuity better than 20/100. The most common causes for visual acuity less than 20/200 were cystoid macular edema, glaucoma, and immunologic graft failure. Using open-loop AC IOLs in patients with pseudophakic or aphakic bullous keratopathy can give good postoperative results and functional vision.     

弹性开放袢前房型人工晶状体植入的报告

目的 探讨弹性开放袢前房型人工晶关体植入方法及疗效。方法 对４４例后囊不完整或无后囊的无晶状体眼，进行Ⅰ期植入１０例，Ⅱ期植入３４例。结果 随访６～２２月，视力≥０．５者３７眼（８４．０９％）。结论 弹性开放袢前房型人工晶状体植入方法简便，疗效好。     

Visual acuity after penetrating keratoplasty for pseudophakic and aphakic bullous keratopathy

PURPOSE: To identify prognostic factors that determine the visual acuity after penetrating keratoplasty (PKP) for bullous keratopathy secondary to cataract surgery. SETTING: Department of Ophthalmology, University Hospital Antwerp, Antwerp, Belgium. METHODS: Twenty-six patients who had PKP for bullous keratopathy were examined before and after surgery. The patients were divided into 3 groups: pseudophakic bullous keratopathy (PBK) after cataract extraction with implantation of a posterior chamber intraocular lens (PC IOL) (Group 1) or an anterior chamber IOL (AC IOL) (Group 2); aphakic bullous keratopathy (ABK) (Group 3). The following parameters were recorded: preoperative and postoperative visual acuity, age at the time of surgery, interval between cataract surgery and development of bullous keratopathy, presence of an AC IOL or a PC IOL, aphakia, and presence of concomitant ocular pathology. RESULTS: Visual acuity improved in Group 1 (0.02 to 0.26); no visual improvement was observed in the other groups. Posterior segment damage occurred in one third of the patients in Group 1 and in all patients in the other groups. Patients with an intact posterior segment had a significantly better visual outcome. In eyes without posterior segment pathology, visual acuity improved from a mean of 0.03 (range 0 to 0.20) to a mean of 0.37 (range 0.03 to 0.90). In eyes with posterior segment pathology, no visual acuity improvement could be obtained. CONCLUSIONS: The most important negative prognostic factors affecting visual acuity were the presence of concomitant ocular pathology, an AC IOL, and a long interval between surgery and the development of bullous keratopathy.     

人工晶状体置换术8例临床分析

目的分析8例人工晶状体(intraocular lens,IOL)置换术的原因、手术技巧和临床效果。方法回顾分析我院2004年1月至2006年12月8例(8眼)患者行IOL置换术术后裸眼视力、矫正视力和并发症。结果行IOL置换的主要原因是IOL脱位(3眼)和人工晶状体度数计算错误(3眼);术后裸眼视力在0.5以上的有7眼,8眼的最佳矫正视力均在0.5以上,手术的主要并发症是玻璃体脱出(2眼)。结论精细的手术技巧、准确的IOL测量、仔细的IOL植入和患者的合理沟通/选择等可有效避免IOL植入术出现并发症。IOL置换是一种即安全又能获得良好视力的治疗方法。     

Retinal detachment after cataract surgery. Surgical results.

The authors studied the results obtained by the Retina Associates in 376 eyes of 361 patients operated on for retinal detachment associated with aphakia or pseudophakia with a postoperative follow-up of at least 6 months. All eyes underwent scleral buckling. The series included 103 eyes with aphakia, 17 eyes with iris-fixated intraocular lens, 111 eyes with anterior chamber (AC) IOL, and 145 eyes with posterior chamber (PC) IOL. The overall success rate for retinal detachment was 93%, without significant difference among the different groups. The aphakia and PC IOL groups had significantly higher prevalence (63% and 60%, respectively) of visual acuity equal to or better than 20/40 compared with the AC IOL group (33%). The prevalence of postoperative corneal edema in the AC IOL group was significantly higher than in the aphakia and PC IOL groups. Preoperative vitreous hemorrhage, large retinal breaks, posterior retinal breaks, total retinal detachment, proliferative vitreoretinopathy, and the need for performing a closed vitrectomy were significant factors in predicting ultimate failure.     

Comparison of posterior capsule opacification between fellow eyes with two types of acrylic intraocular lens

PURPOSE: To compare the degree of posterior capsule opacification (PCO) and visual function between fellow eyes that received two different types of hydrophobic acrylic intraocular lenses (IOLs). METHODS: Forty-five patients underwent bilateral phacoemulsification and implantation of an Alcon AcrySof IOL (MA60AC) in one eye and an AMO Sensar IOL (AR40e) in the fellow eye. The PCO density value was measured using the Scheimpflug videophotography system at 1, 6, 12, and 24 months after surgery. The incidence of eyes that required a neodymium:YAG (Nd:YAG) laser capsulotomy, visual acuity, and contrast sensitivity with and without a glare source were also examined. RESULTS: The mean PCO value did not show a significant increase in either the AcrySof MA60AC or Sensar AR40e IOL groups, and was similar between the two groups throughout the 24-month follow-up period. The incidence of Nd:YAG laser capsulotomy was also the same between the groups. No significant difference was found in mean visual acuity between the two IOL groups during the follow-up, and there was no significant difference in photopic or mesopic contrast visual acuity with and without a glare source at 1 and 24 months after surgery. Conclusion: The degree of PCO in eyes with an AcrySof IOL are almost the same as that in eyes with a Sensar IOL, with the results that visual acuity and contrast sensitivity with and without glare are similar.     

Longitudinal study of intraocular lens exchange

PURPOSE: To analyze the indications for intraocular lens (IOL) exchange, interval between the first IOL implantation and the exchange, type and mix of IOLs used, effect on vision, and frequency of complications. SETTING: Cincinnati Eye Institute-Cincinnati-Ohio-USA. METHODS: This retrospective study comprised 49 eyes of 49 adult patients who had IOL exchange between 1986 and 2002 performed by the same surgeon. The mean age was 70 years old, and 55% were women. The mean interval between surgeries was 53.8 months and the mean follow-up, 35.6 months. The patients were divided into 2 groups according to the type of IOL originally implanted: anterior chamber (AC) or posterior chamber (PC). RESULTS: There were 15 eyes with an AC IOL and 34 eyes with a PC IOL. The difference in mean age and follow-up were not statistically significant between groups. The mean interval between the primary surgery and IOL explantation was 82.3 months in the AC IOL group and 37.9 months in the PC IOL group. The main reason for IOL exchange was inflammation (53.34%) and dislocation/decentration (85.30%), respectively. The preoperative best corrected visual acuity was similar in both groups, and visual acuity was maintained or improved in 80%. Vitreous prolapse was the main intraoperative complication. CONCLUSIONS: The primary indication for IOL exchange was intraocular inflammation in patients with an AC IOL and IOL malposition in patients with a PC IOL. The results confirm the safety and positive visual outcome in this complex group of patients.     

Visual acuity and contrast sensitivity: AcrySof ReSTOR apodized diffractive versus AcrySof SA60AT monofocal intraocular lenses

PURPOSE: To compare the visual acuity and contrast sensitivity in eyes with the AcrySof ReSTOR multifocal intraocular lens (IOL) (Alcon) and eyes with the monofocal AcrySof SA60AT IOL. SETTING: Policlinico Umberto I, Department of Ophthalmology, Rome, and private clinical practice, Rome, Italy. METHODS: One hundred eyes had phacoemulsification cataract extraction and implantation of a ReSTOR multifocal IOL in the capsular bag. Inclusion criteria were corneal astigmatism less than 1.5 diopters (D), myopia less than 4.0 D, and no associated ocular disease. A complete ophthalmic examination, including uncorrected visual acuity, best spectacle-corrected visual acuity, and contrast sensitivity, was performed 6 months postoperatively. Results were compared with those in 40 eyes with the AcrySof monofocal IOL single-piece IOL. RESULTS: In the multifocal group, 90 eyes (90%) had an uncorrected distance visual acuity of 20/25 or better (logMAR<0.10) and an uncorrected near visual acuity at 35 cm of J3 or better (logMAR 0.14). The multifocal group and monofocal group had similar distance uncorrected and best corrected visual acuities; however, the multifocal group had significantly better near uncorrected acuity. The mean contrast sensitivity values were 18.28 dB (static program) and 17.95 dB (dynamic program) in the multifocal group and 19.18 dB (static program) and 21.2 dB (dynamic program) in the monofocal group. CONCLUSIONS: The ReSTOR multifocal IOL provided a satisfactory full range of vision; 92% of the patients achieved total spectacle independence. Contrast sensitivity was lower than with the SA60AT monofocal IOL.