两种不同材料折叠人工晶状体植入术后后发障的临床观察

为探讨人工晶状体(IOL)材料与后囊膜混浊(PCO)发生的关系,我们随访了门诊施行超声乳化白内障摘除术(PHACO)联合疏水性丙烯酸IOL(AcrySof)或疏水性硅凝胶IOL(CeeOn911A)植入的患者术后一年PCO的发生情况。一、材料和方法选择2002～2004年在北京协和医院和澳门仁伯爵医院老年性白内障患者中行PHACO术联合疏水性AcrySofIOL或疏水性硅凝胶CeeOn911AIOL两种不同材料折叠IOL植入的病例;除外合并糖尿病、高度近视、青光眼、葡萄膜炎等患者。随访资料完整、手术中顺利将IOL植入囊袋内且随访时间达一年的患者119例(137眼)。其中植…     

CANON-STAAR注入式植入折叠人工晶体手术的临床疗效观察

目的 :观察分析CANON -STAAR注入式植入可折叠人工晶体手术的临床效果 ,寻找容易植入效果更好的折叠人工晶体。方法 :对 90例 (10 0只眼 )白内障患者行颞侧巩膜切口的超声乳化白内障摘除术联合CANON -ATAAR注入器植入的可折叠人工晶体手术 ,观察其术中、术后并发症 ,术后视力 ,术后人工晶体在囊袋内的位置。结果 :10 0只眼术中均能顺利的将人工晶体植入囊袋内 ,术后 12个月裸眼视力≥ 0 5者 74眼 (82 2 % ) ,所有人工晶体均能位于囊袋内 ,未发生后囊膜皱褶。结论 :注入式植入人工晶体实现真正的小切口作用 ,术后损伤小、恢复快、炎症轻。     

Acrysof与Centerflex折叠一片式人工晶状体植入术临床观察

目的 观察美国Acrysof与英国Centerflex折叠一片式人工晶状体在白内障超声乳化手术植入后的临床效果。方法随机选择132例老年性白内障患者行白内障超声乳化手术，术中62例(62只眼)植入美国Acrysof折叠一片式人工晶状体，70例(70只眼)植入英国Centerflex折叠一片式人工晶状体，观察术中植人情况、人工晶状体的位置及稳定性和术后角膜反应、前房反应、术后视力、角膜内皮细胞密度、后囊膜增生情况等，随访时间3个月。结果两种人工晶状体植入术后矫正视力均良好，眼内反应轻，晶状体植入囊袋内位置稳定，未见明显后囊膜混浊及增生，角膜内皮细胞密度术后与术前比较均无显著差异。结论美国Acrysof与英国Centerflex折叠一片式人工晶状体在白内障超声乳化手术后植入效果满意，值得临床推广应用。     

晶状体囊袋张力环在预防后囊膜混浊中的应用

后囊膜混浊是白内障摘出联合后房型人工晶状体植入术后导致视力下降的最常见并发症之一 ,而术中植入囊袋张力环可有效地降低后囊膜混浊的发生 ,我们就囊袋张力环在白内障术中的应用及发展情况加以综述     

人工晶体囊袋内植入对白内障术后后囊混浊发生率的影响

目的回顾性研究白内障囊外摘除和白内障囊外摘除联合囊袋内人工晶体植入术后囊混浊发生率。方法对１８５例（２３４眼）老年性白内障囊外摘除和１０２例（１０９眼）老年性白内障囊外摘除联合囊袋内人工晶体植入术后进行６月～３年（平均２６月）随访,观察其后囊混浊情况。结果前者２３４眼中有８９眼（３８％）发生后囊混浊,后者１０９眼中有１８眼（１７％）发生后囊混浊,二者有显著性差异（Ｐ＜０．０５）。结论白内障囊外摘除联合囊袋内人工晶体植入能降低后囊混浊发生率。     

Sensar人工晶状体植入术后的临床观察

目的观察和评估白内障超声乳化植入Sensar人工晶状体的临床效果。方法对92例（106只眼）年龄相关性白内障,应用表面麻醉颞侧透明角膜切口,行白内障超声乳化吸除联合Sensar人工晶状体植入术。观察术后视力、术后眩光、人工晶状体在晶状体囊袋内的位置及后囊膜的混浊等的变化。结果术后观察12～28个月,平均19.4个月,最佳矫正视力≥0.5者达100%,≥1.0者67眼（占63.21%）,患者在日常生活中无视物不适,无眩光,人工晶状体居后囊中央,与后囊膜紧贴,后囊膜平展,Ⅰ级后囊膜混浊95眼（89.62%）,Ⅱ级后囊膜混浊9眼（8.49%）,Ⅲ级后囊膜混浊2眼（1.89%）。结论Sensar人工晶状体植入术后视物舒适,能减少眩光,能减少后发性白内障。     

人工晶体眼YAG激光后囊膜切开术后继发视网膜脱离5例

白内障囊外摘除、后房型人工晶体植入已成为目前白内障手术最常用的方法。手术后很多因后囊膜混浊而影响视力需行Nd：YAG激光后囊膜切开以恢复视力。我们报告5例病人行YAG激光后囊膜切开术后发生视网膜脱离。一、临床资料5例5只眼白内障囊外摘除、后房型人工晶体植入术后在本院     

人工晶体植入术后后囊膜皱褶的成因分析和防治

目的探讨白内障囊外摘除人工晶体植入术后晶体后囊膜皱褶症的成因、对视力的影响和防治方法.方法选择A组(后囊膜皱褶组)和B组(对照组)各56例病人56只眼,进行视力对比分析,对A组病人晶体后囊膜皱褶进行详细观察,对后囊膜皱褶YAG激光治疗前后进行检验.结果晶体后囊膜皱褶因不同的起因可造成放射形或条形皱褶.A组病人视力明显低于B组病人,有显著差异(P＜0.001).激光治疗后视力明显提高(P＜0.01).结论白内障囊外摘除人工晶体植入术后晶体后囊膜皱褶是引起视力下降的原因之一.用激光晶体囊膜截开术治疗效果明显.     

白内障超声乳化吸除联合人工晶状体植入Ⅰ期后囊膜连续环形撕除的临床观察

目的探讨白内障超声乳化吸除联合人工晶状体植入术中Ⅰ期后囊膜连续环形撕除的临床疗效。方法对53例(60只眼)先天性白内障和后囊混浊的老年性白内障,施行白内障超声乳化吸除联合人工晶状体植入,同时行Ⅰ期后囊膜连续环形撕除,术后观察眼压、人工晶状体位置、视轴区后发障等情况。结果术中人工晶状体均顺利植入囊袋;54只眼术后视力较术前提高,术后24小时后眼压正常;术后随访3个月~2年,无发生玻璃体疝入前房,未发现人工晶状体异位或夹持,无一例出现后发障、视网膜脱离。结论白内障超声乳化吸除联合人工晶状体植入Ⅰ期后囊膜连续环形撕除是可行、安全的,能有效地治疗后囊膜混浊,预防后发障。     

眼前节毒性综合征一例

患者男性,55岁。因左眼白内障于2010年5月在我院行白内障超声乳化联合人工晶状体植入术。术前眼部检查：右眼为人工晶体眼,右眼视力1.0。左眼视力：0.1（矫正不提高）,左眼角膜透明,前房常深,瞳孔正圆,直径3 mm,对光反射灵敏。左眼晶体核Ⅱ级,后囊下混浊。玻璃体少量混浊。眼底未见异常改变。角膜内皮细胞计数：2791.6个/mm2。六角型细胞占69％。眼压：16 mm Hg,全身无糖尿病、高血压及其他免疫性疾病史。于表面麻醉下行白内障超声乳化联合人工晶状体植入术,手术顺利,术中后囊膜完整,人工晶状体囊袋内植入。     

Long-term results of the foldable CeeOn Edge intraocular lens

PURPOSE: To determine the long-term efficacy and safety of the foldable silicone CeeOn Edge(R) model 911 intraocular lens (IOL). SETTING: Eye Clinic, Klinikum Minden, Germany. METHODS: A high-refractive-index silicone lens with a sharp edge was implanted after phacoemulsification in 42 eyes of 36 patients. Best corrected visual acuity (BCVA) and occurrence of complications were evaluated during a 3 year follow-up. RESULTS: No significant postoperative complications were seen. At 3 years, 26 eyes of 22 patients were available for examination. The BCVA was 0.5 (20/40) or better in 92% of eyes and 1.0 (20/20) or better in 39%. No posterior capsule opacification (PCO) was observed, and neodymium:YAG capsulotomy was not indicated in any patient. CONCLUSIONS: This pilot study indicates that the performance and safety of the foldable silicone CeeOn Edge lens are excellent. The results support the theory that a sharp edge on the IOL prevents the development of PCO.     

Foldable posterior chamber intraocular lens implantation in the absence of capsular and zonular support

PURPOSE: To implant foldable posterior chamber intraocular lenses in the absence of capsular and zonular support. METHODS: Case reports. In two patients, two eyes with aphakia, lack of capsular or zonular support, and contact lens intolerance underwent the implantation of a silicone and an acrylic foldable posterior chamber intraocular lens, respectively. RESULTS: In the two eyes, final visual acuity was 20/25 and 20/50, respectively. No intraoperative vitreal, retinal, or choroidal complications were noted. The postoperative recovery was rapid, and there was minimal induced astigmatism. CONCLUSIONS: The implantation of foldable posterior chamber intraocular lenses in aphakic eyes without capsular and zonular support may result in fewer intraoperative complications. It also allows for faster postoperative recovery and less postoperative astigmatism.     

Posterior capsule opacification after phacoemulsification: silicone CeeOn Edge versus acrylate AcrySof intraocular lens

PURPOSE: To compare the rates and morphologic features of posterior capsule opacification (PCO) after small-incision phacoemulsification and in-the-bag implantation of 2 foldable intraocular lenses (IOLs) over an 18-month follow-up. SETTING: Departments of Ophthalmology, Hospital of Conegliano, Conegliano, and Maggiore Hospital of Bologna, Bologna, Italy. METHODS: In an open clinical study, 78 cataract patients were randomly selected to have implantation of a silicone CeeOn Edge (Pharmacia) or acrylate AcrySof (Alcon) IOL after phacoemulsification cataract surgery. All the patients were operated on using a standard technique and in-the-bag IOL implantation. One eye in each patient was studied. Morphologic evaluation of PCO was performed using Evaluation of Posterior Capsule Opacification software. RESULTS: At 18 months in the CeeOn Edge group, 36 eyes (90%) had a clear posterior capsule and 4 (10%) had PCO that did not affect visual acuity. In the AcrySof group, 26 eyes (68%) had a clear posterior capsule, 11 (29%) had PCO that did not affect visual acuity, and 1 (3%) had PCO with a decrease of 2 or more lines of visual acuity that required a neodymium:YAG laser capsulotomy. No eye developed Elschnig pearls or stretched folds in the bag. The postoperative best corrected visual acuity ranged from 0.8 to 1.0 in 96% in the CeeOn Edge group and in 92% in the AcrySof group. No IOL haze or discoloration was observed in the CeeOn Edge group. Mild IOL decentration and tilting occurred in 4 AcrySof eyes; however, no glistenings were found any AcrySof IOL. CONCLUSIONS: Both the CeeOn Edge and AcrySof groups had a low incidence of PCO after an 18-month follow-up. The CeeOn Edge group had significantly less PCO than the AcrySof group. These results confirm that IOLs with square truncated edges create a barrier effect at the optic edge, reducing the overall incidence of PCO.     

折叠人工晶状体无缝线固定悬挂术临床效果观察

目的:观察后房型三体折叠式丙烯酸非球面人工晶状体经透明角膜切口植入并巩膜隧道无缝线固定悬挂术后的临床效果。方法:观察后房型三体折叠式非球面人工晶状体经透明角膜切口植入并巩膜隧道无缝线固定悬挂术的临床效果。对视力、超声生物显微镜(UBM)显示的晶状体位置、眼内反应等参数进行术前术后对比。结果:随访3～12(平均6.5)mo,术后矫正视力:1.0～1.5者8眼(33.3%),0.5～0.9者13眼(54.2%),0.1～0.4者3眼(12.5%),手术后裸眼及矫正视力较术前均有显著性提高(P<0.01)。UBM显示人工晶状体体部平面与角膜内皮间距,和睫状突平面与角膜内皮间距之间差异无统计学意义(P>0.05),与囊袋内植入人工晶状体者位置相似,术后未出现明显睫状体脱离、锯齿缘离断或虹膜根部形态异常等。24例人工晶状体悬挂植入术均手术顺利,无严重眼内感染或炎症等,未出现睫状体脱离或视网膜脱离等并发症,少数出现短暂眼内压增高。结论:选择3.0～6.0mm透明角膜切口行后房型三体折叠式人工晶状体植入并巩膜隧道无缝线固定悬挂术,是白内障超声乳化吸除术中弥补手术失误,治疗外伤性晶状体脱位或白内障,治疗先天性晶状体半脱位等疾病,提高视力的安全有效方法,远期疗效有待长期随访观察。     

Assessment of MemoryLens in own materials

PURPOSE: The aim of this study is the assessment of results of cataract phacoemulsification with the implantation of MemoryLens. Phacoemulsification is the most often used method of cataract extraction nowadays. This method led to shorter incision and reduction of postoperative astigmatism. Using phacoemulsification method the foldable intraocular lenses are applied. MATERIAL AND METHODS: The cataract phacoemulsification with implantation of the only one prefolded intraocular lens were done in 25 eyes. RESULTS: Fast visual acuity recovery and no postoperative complications were observed. CONCLUSION: MemoryLens are easy to insert, and the effectiveness of this method is similar to implantation of other intraocular foldable lenses.     

小瞳孔白内障的超声乳化及折叠式人工晶状体植入术

目的探讨小瞳孔白内障的超声乳化及折叠式人工晶状体的手术技巧和临床效果。方法临床确诊的小瞳孔白内障患者46例54眼,经透明角膜隧道切口,采用钝性分离的方法扩大瞳孔,行环行撕囊、双手原位超声乳化及折叠式人工晶体囊袋内植入手术。结果术后随访5～12月,术后视力提高46眼占85.19%,视力≥0.5者34眼占62.96%,所有患者的瞳孔保持生理性圆形或是近圆形。手术并发症主要有角膜水肿、前房纤维素性渗出、后囊破裂。结论掌握合理的手术技巧,小瞳孔白内障的超声乳化术同样可以取得良好的手术效果。     

Akreos Adapt人工晶状体十字形袋／沟固定法在后囊大破孔时的应用

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.     

成人后极性白内障超声乳化吸出术疗效观察

目的探讨成人后极性白内障超声乳化摘出联合人工晶状体植入术的手术技巧、术中术后并发症的处理方法及手术效果。方法对我院临床确诊的17例(26眼)成人后极性白内障患者行超声乳化摘出联合人工晶状体植入,观察术中后囊膜情况、术后视力、后囊膜混浊和并发症的发生情况。同时与我院同期普通白内障超声乳化术中后囊膜破裂发生率进行对比。结果 17例26眼成人后极性白内障患者术中可见后囊膜完整透明者12眼,后囊膜完整伴不同程度混浊者7眼,后囊膜中央局限性缺损者2眼,但术中未发生玻璃体溢出。术中后囊膜破裂5眼,发生率为19.23%。同期普通白内障超声乳化术中后囊破裂发生率为1.81%,二者相比差异有统计学意义(P<0.05)。成人术后视力均较术前有不同程度提高。术后9眼角膜轻度水肿,经治疗后1周内恢复透明,3眼前房纤维素样渗出,经治疗后痊愈。结论后极性白内障虽具有特殊性,后囊膜破裂发生率明显高于普通白内障。只要给予足够重视,行超声乳化摘出联合人工晶状体植入术是较好的手术方法。     

Foldable Lens Explantation and Exchange：The Reason and Solution

Objective: To report the explantation and exchange of Hydrophilic Acrylic foldableintraocular lens (IOL) on 14 patients who had visual disturbances caused by the changeof transparence on optic.Methods: Sixteen Hydrophilic Acrylic foldable intraocular lenses from 14 patients whopresented with decreased visual acuity from 6 months to 1 year after normalphacoemulsification and IOL implantation associated with extensive transparent changeon optic of the lens. The lenses were explanted with the bisection technique. All the eyeswere reinserted with Acrysof foldable lenses.Results: Sixteen lenses were removed successfully and exchanged with the new lens inthe capsule. The posterior capsular rupture and vitreous loss were found in the first twocases. One of them had the zonulysis due to the radial tear of the anterior capsule duringthe enlargement of the capsular opening. The anterior vitrectomy was performed with IOLfixed on the ciliary sulcus. The visual acuity of all the patients improved obvi     

闭角型青光眼伴白内障联合手术的临床观察

目的 观察超声乳化联合小梁切除术治疗闭角型青光眼伴白内障的临床疗效.方法 32例（48眼）患者行白内障超声乳化吸出及后房型折叠人工晶状体植入联合小梁切除术,术后随访6个月,分析术后眼压、视力等情况.结果 术前眼压30～45 mmHg（1 mmHg =0.133 kPa）,术后随访最终时眼压8 ～ 15 mmHg,术后矫正视力0.4 ～1.0者30眼（62.5％）.结论 超声乳化吸出后房型人工晶状体植入联合小梁切除术治疗闭角型青光眼伴发白内障安全有效.