后房型人工晶体植入意外、错误的发生原因及手术干预

目的　探讨后房型人工晶体植入意外、错误的发生原因和手术干预方法。方法　回顾白内障摘除手术无并发症发生、人工晶体植入过程中出现意外的 14例 (14只眼 )患者的临床资料 ,归纳进一步手术干预的方法 ,并观察手术疗效和并发症。结果　屈光度选择错误 (3 5 . 7% )、人工晶体意外反向植入 (5 0 . 0 % )是需要进一步手术干预的主要原因。手术干预方法包括 :人工晶体置换术、翻转术、前囊周边造孔术等。术后视力 0 . 5～ 1.2。未发现严重并发症。结论　正确测算人工晶体屈光度、熟练掌握植入技术可减少白内障摘除人工晶体植入术中、术后人工晶体源性并发症的发生 ,人工晶体翻转术、置换术等是安全、有效的补救方法.

Surgical intervention for incorrect implantation of posterior chamber intraocular lens

Objective To determine the factors that contribute to the error and accident in posterior chamber intraocular lens (IOL) implantation and discuss the strategy to rescue. Methods The clinical data of 14 patients who received uneventful cataract extraction procedure with incorrect implantation of posterior chamber lens were reviewed. The methods for subsequential surgical intervention were classified and the surgical effects and complications were explored. Results The main indications for surgical intervention included unsatisfactory refractive outcome and inappropriate IOL power (35.7%), reverse settlement of the IOL (50%). IOL exchange or flip or peripheral anterior capsulotomy was engaged in the subsequential intervention. The final visual acuity ranged from 0.5 to 1.2. No severe complications were documented.Conclusions Appropriate intraocular lens power selection and improved implantation technique are essential to diminish IOL-related complications. IOL exchange and flip are effective rescue methods.