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玻璃体切割术后IOL混浊病例的临床与实验研究 被引量:1
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作者 毛世兰 谢晋 +3 位作者 刘廷 万磊 陈楠 代云海 《中华眼视光学与视觉科学杂志》 CAS CSCD 2023年第1期10-17,共8页
目的:探讨玻璃体切割术(PPV)后人工晶状体(IOL)混浊的病例特点及相关危险因素。方法:回顾性研究。连续纳入2007年2月至2022年2月在山东第一医科大学附属青岛眼科医院发现的全部PPV术后出现IOL混浊的病例资料11例,选取其中2枚取出且保存... 目的:探讨玻璃体切割术(PPV)后人工晶状体(IOL)混浊的病例特点及相关危险因素。方法:回顾性研究。连续纳入2007年2月至2022年2月在山东第一医科大学附属青岛眼科医院发现的全部PPV术后出现IOL混浊的病例资料11例,选取其中2枚取出且保存良好的IOL进行体外光镜、扫描电镜、激光共聚焦显微镜检测以及能谱分析。结果:11例患者年龄为23~76(63.3±15.0)岁,发现IOL混浊与PPV间隔时间为24~180(82.2±45.7)个月。11例患者中8例有视网膜光凝史,5例有眼内硅油/气体注入手术史,1例有青光眼手术史。11例患者中糖尿病6例,高血压5例。患者所用IOL类型及临床处置情况分别为:9例(9/11)为亲水性丙烯酸酯,型号分别为860UV(1例,已取出)、Akreos Adapt AO(2例,已取出1例)和具有疏水涂层的亲水性L-312(6例,已取出4例);另外2例(2/11)为疏水性丙烯酸酯MA60MA(未取出)。2枚混浊的IOL检测情况如下:第1枚是860UV型IOL,混浊部位主要集中于光学部前表面,光镜及扫描电镜下呈弥漫、凹凸不平蚯蚓状、地嵴状,襻部及周边未见明显沉积物;激光共聚焦显微镜显示混浊主要集中在前浅层,深度大约为IOL整体厚度的前6.9%;能谱分析显示,按元素组成比例高低排列为碳、氧、钙、磷、硅和镁元素。第2枚是Akreos Adapt AO型IOL,混浊主要处于光学区中央,光镜及扫描电镜下呈粗糙、小圆形的砂粒,襻部也散在累及,呈较为致密的砂粒状;共聚焦显微镜显示混浊区域更深,大约为IOL整体厚度的前12.5%;能谱分析显示,按元素组成比例高低排列为碳、氧和硅元素。结论:PPV后不同类型丙烯酸酯IOL均有可能发生混浊,且IOL混浊的形态和表面沉积物各不相同。 展开更多
关键词 人工晶状体 混浊 玻璃体切割术 材料 钙化 闪辉
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Late postoperative opacification of a new type hydrophilic acrylic intraocular lens
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作者 Jin Xie Xinyi Zang +3 位作者 shilan mao Jie Sun Ting Liu Yunhai Dai 《Advances in Ophthalmology Practice and Research》 2023年第3期134-140,共7页
Background:To report the clinical consequences and laboratory characteristics of late postoperative opacification of a hydrophilic acrylic intraocular lens(US-860UV IOL)as well as the prognosis of IOL replacement.Meth... Background:To report the clinical consequences and laboratory characteristics of late postoperative opacification of a hydrophilic acrylic intraocular lens(US-860UV IOL)as well as the prognosis of IOL replacement.Methods:Forty medical records(42 eyes)of patients with US-860UV IOL opacification reporting decreased or lost vision who underwent IOL explantation between 2017 and 2019 were reviewed.Explanted IOLs were analyzed by slit-lamp examination,confocal microscopy,scanning electron microscopy(SEM)and energy-dispersive X-ray spectroscopy(EDS)at the Shandong Key Laboratory of Ophthalmology,Shandong Eye Institute,Shandong First Medical University,and Qingdao University of Science and Technology,Qingdao,China.Results:The mean age of the 40 patients was 74.837.57(63–92)years.The mean interval between cataract surgery and diagnosis of opacification was 32.388.76(17–48)months.Systemic diseases were found without statistical correlations,the most frequent being arterial hypertension,coronary heart disease,and diabetes mellitus.Visual acuity improved from 1.42±1.03 to 0.31±0.16(logMAR)after IOL replacement.SEM,EDS and alizarin red staining showed uniformly distributed,diffuse,milk-white opacification,with calcium and phosphorus deposits on the optic and haptic surfaces that could be dissolved in 1%HCl.Conclusions:Calcium and phosphorus deposition was the main cause of hydrophilic acrylic US-860UV IOL opacification.IOL replacement can safely and effectively improve the visual acuity of patients. 展开更多
关键词 Hydrophilic IOL OPACIFICATION Calcium IOL replacement
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