Posterior Chamber IOL Implantation in Traumatic Cataract with Injured Complications

Twenty-five cases of posterior chamber IOL implantation intraumatic cataract with complications associated with primary injury werereported.The operating methods were described and the post-operative com-plications were discussed.Seventy-two percent of patients have the correctvision over 20/40.It is suggested that the posterior chamber IOL can be im-planted in traumatic cataract with some injured complications.EYE SCIENCE1992;8:111-112.

Pattern of Refractive Correction and Timing of Stage Ⅱ IOL Implantation after Congenital Cataract Extraction

Congenital cataract occurs during infancy when the axial length and corneal and visual function are in the sensitive stages of rapid development..Inappropriate surgical intervention not only fails to restore visual function,.but also causes irreversible serious influences upon eyeball development in children diagnosed with congenital cataract. At present, the uncertainty of selection of intraocular lens(IOL) degrees during the eyeball development period is averted by using a main treatment of congenital cataract that includes two-stage surgery:.stage I cataract extraction and stage II IOL implantation. However, the accurate selection of a refractive correction method and the timing of IOL implantation during stage II surgery for aphakic eyes remains controversial following stage I cataract extraction..This review retrospectively summarizes the current progress and existing problems indicated by related recent studies focusing on refractive correction pattern and IOL implantation timing.

The Clinical Study of Healon 5 in Phacoemulsification and IOL Implantation

Purpose: To compare a new ophthalmic viscoelastic device (OVD) Healon 5 with twoother kinds of OVDs commonly used in China during phacoemulsification and intraocularlens (IOL) implantation in terms of removal time, intraocular pressure, corneal andanterior chamber response.Methods: This prospective randomized study, in which patients and observers aremasked, comprises niety eyes. They were randomly divided into 3 groups with differentOVDs. Healon 5 (sodium hyaluronate 5 000 2.3 % ) was compared with Healon GV(sodium hyaluronate 7 000 1.4 % ) and Iviz (sodium hyaluronate 1.0 % ) . Thesurgeries were performed with temporal corneal incision, phacoemulsification in situ andfoldable lens intracapsular implantation. The characteristic and the removal time of theviscoelastic material as well as the postoperative IOP, corneal reaction and anteriorchamber reactions of the eyes were observed preoperatively and 24 hrs postoperatively.Exclusion criteria were glaucoma, a preoperative dilated pupil diameter smaller than 5.0mm, proliferative diabetic retinopathy, significant corneal pathology or a history ofuveitis.Results: The removal time was 47.42 ± 13.09 seconds in Healon 5, 16. 50 ± 5.45 inHealon GV and 15.83±7.40 in Iviz. The removal time of Healon 5 group wassignificantly longer than that of the other groups ( P =0. 000) . There is no significantIOP change 24 hours postoperatively and the difference of intraocular pressure amongthree groups was not significant ( P ＞ 0.05). Healon 5 group had the slightest cornealand anterior chamber response, followed by Healon GV and Iviz.Conclusion: Although takes longer time to remove, Healon 5 is an ideal viscoelasticmaterial for its superior space maintenance capacity and high dispersity which providessuperior protection of endothelial cells compared to Healon GV and Iviz.

Case report:simultaneous femtosecond laser astigmatic keratotomy and toric intraocular lens implantation in femtosecond laser-assisted cataract surgery in a patient with surgically induced high corneal astigmatism

Background:Femtosecond laser astigmatic keratotomy(FSAK)and toric intraocular lens(IOL)implantation have been studied individually for comparison to treat astigmatism at cataract surgery.We report a case of surgically induced high corneal astigmatism by laser thermal keratoplasty(LTK)in a patient with cataract who was successfully treated with simultaneous combination of FSAK and toric IOL implantation with femtosecond laser-assisted cataract surgery(FLACS).This is the first report of both procedures combined simultaneously,with or without history of LTK.Case Description:A 68-year-old male presented with a history of LTK with two enhancements each eye in 2004,with subsequent surgically induced high corneal astigmatism,and with age-related nuclear cataract of both eyes.IOL master demonstrated+7.71 diopters of astigmatism at 163 degree right eye and+3.29 diopters of astigmatism at 4 degree left eye.After extensive discussion of the risks and benefits,the patient agreed to undergo FLACS with FSAK with two 61 degrees of relaxation incisions(RIs)and toric IOL(Alcon SN6AT9)right eye;FLACS with toric IOL(Alcon SN6AT7)alone left eye.At 2-year follow-up,uncorrected visual acuity was 20/30 right eye,20/25 left eye.His best corrected visual acuity was 20/25(+0.25+1.00 axis 21)right eye and 20/20(plano+0.25 axis 90)left eye;his best corrected near visual acuity was J1+with add+2.50 diopters right eye and left eye.Conclusions:Patients with age-related cataract and LTK induced high corneal astigmatism can hardly be sufficiently treated with FSAK or toric IOL alone at the time of cataract surgery.An effective way is to combine large FSAK and toric IOL of the highest cylindrical power of T9,in our case,simultaneously,which can achieve an excellent long term visual outcome.

Full-vision maintenance in extra-high myopia from implantable collamer lens to trifocal intraocular lens implantation

Dear Editor,I am Dr.Ye Shen from the Department of Ophthalmology,the First Affiliated Hospital,College of Medicine,Zhejiang University,Hangzhou,China.I write to share my experience of full-vision maintenance in patient with extrahigh myopia from implantable collamer lens （ICL） to trifocal intraocular lens （IOL） implantation.

Recent Advances in IOL Surgery

Tremendous progress is made in recent time in the field of Ophthalmology especially after advent of IOL implantation surgery. Recent advance in anaesthesia/lOL, designs/IOL, quotings/cantering, techniques/advances in operating microscope and advances in suture materials/needles etc. will be discussed.

Ciliary body detachment after secondary intraocular lens implantation in childhood

Dear Sir,Iam Dr.Li-Na Meng,from the Qingdao Eye Hospital,Shandong Eye Institute,Shandong Academy of Medical Sciences,Qingdao,China.I want to present a rare case of secondary intraocular lens(IOL)implantation in an11-year-old boy who developed the complication of ciliary body detachment.When he was 2 years old,the boy underwent bilateral cataract extraction for congenital cataract in the other

Evaluation of the Effectiveness of Preloaded IOL Injectors in Surgical Time

Background: The implantation of the intraocular lens (IOL) is still subject to error and complication, as it can result in traumatic opening of the IOL leading to rupture of the posterior capsule and zonular dialysis, it takes time to train paramedic teams to assemble such IOLs with the manual injectors. Moreover, there is a potential risk of comtamination and endophthalmitis as there is manipulation of the IOL and cartridge. The preloaded IOLs tend to reduce those unwanted results and may optimize the surgical time. Purpose: The aim of this study is to compare the effectiveness and implantation time between three injectors and three intraocular lenses, two pre-loaded and one conventional. Methodology: Videos of thirty patients undergoing cataract surgery from December 2019 to December 2020 at the Hospital Oftalmológico de Brasília (HOB), Brasília, Brazil were included in this observational, analytical retrospective study, non randomized. All patients had their surgeries recorded, from which the time of injection and opening of the intraocular lens (IOL) was extracted, 20 eyes were implanted with preloaded intraocular lens, and 10 eyes with conventional IOL implant. The patients were divided into three groups with similar eye characteristics. The first received the AutonoMeTM (CE) injector with the Clareon® IOL, the second the IsertTM injector (I) with the Hoya® IOL, and the third was injected with Johnson & Johnson Platinum 1 Series injector used to deliver Sensar® One AAB00 lens. The Welch test and Tukey’s Post Hoc test were used in the statistical analysis. Results: It was observed that there was a statistical significance regarding the presence of a haptic stuck (5 Clareon vs 0 Sensar and Hoya), between the mean opening time of the IOL optics Sensar One, Hoya and Clareon (25.00 vs 31.40 vs 11.70 s, p < 0.001) and between the total time (the injection time more the opening time of the IOL) in relation to Hoya and Clareon lenses (39.50 s vs 19.60 s, p < 0.001);the total time of the Sensar IOL was 31.30 s. The opening time of the IOL optics was significantly longer for the Sensar One and Hoya groups compared to Clareon group, and the total time of Hoya group was significantly longer compared to the total time of the Clareon group. Conclusion: The study demonstrated that the choice of injector and IOL set can significantly affect the total time of IOL implantation. However, there was no difference regarding complications and collateral damage depending on the set chosen for the implant.

FLACS-IOL手术对白内障患者术后MIOL的偏移率及视觉质量的影响

目的:探讨飞秒激光辅助超声乳化手术联合人工晶状体植入(FLACS-IOL)对白内障患者术后多焦点人工晶状体(MIOL)偏移率及视觉质量的影响。方法:前瞻性研究。选取我院2021-01/2022-12收治的白内障MIOL植入患者95例108眼,根据患者意愿选择手术方式并分组为FLACS组(51例56眼),Phaco组(44例52眼)。对比两组手术时间、前囊切开直径、有效超声时间(EPT)、超声乳化能量释放量(CDE)、裸眼远视力(UCDVA)、最佳矫正远视力(BCDVA)、术后3 mo的IOL偏心距离、偏移率及3 mm瞳孔下全眼总高阶像差(HOA)、三叶草差(Trefoil)及彗差(Coma)。结果:FLACS组手术时间明显短于Phaco组,EPT、CDE均明显低于Phaco组(均P<0.05);两组前囊切开直径无差异(P>0.05)。FLACS组UCDVA在术后1 wk,3 mo优于Phaco组(均P<0.05);两组术后1 wk,3 mo的UCDVA和术后3 mo的BCDVA比较均有差异(P<0.05)。术后3 mo,FLACS组IOL偏心距离小于Phaco组,偏移率明显低于Phaco组(均P<0.05)。在3 mm瞳孔直径下,两组术后3 mo的全眼HOA、三叶草差及彗差均较术前减少(P<0.05),FLACS组术后3 mo的全眼HOA、三叶草差与Phaco组比较均有差异(P<0.05),FLACS组术后3 mo的彗差与Phaco组比较无差异(P>0.05)。结论:FLACS-IOL手术可有效降低白内障患者术后IOL偏移率,获得更好的视觉质量。

散光矫正型IOL植入术和飞秒激光松解联合白内障摘除术治疗白内障合并低度角膜逆规散光患者的效果分析

目的:探讨散光矫正型人工晶状体(toric intraocular lens,Toric IOL)植入术和飞秒激光松解联合白内障摘除术治疗白内障合并低度角膜逆规散光患者的效果。方法:选取2021年3月至2023年7月在开封市中心医院接受治疗的白内障合并低度角膜逆规散光患者126例,根据手术方式将其分为对照组(n=63)给予飞秒激光松解联合白内障摘除术治疗,观察组(n=63)给予Toric IOL植入术联合超声乳化白内障吸除术,对两组患者的裸眼远视力、最佳矫正视力、散光相关指标、角膜内皮计数、总高阶像差和视觉质量进行比较。结果:术后3个月,裸眼远视力和最佳矫正视力均优于术前,且观察组裸眼远视力优于对照组(P<0.05),两组患者的最佳矫正视力无统计学意义(P>0.05);术后3个月,两组患者的CJ0、CJ45、散光度数均低于术前,且观察组均低于对照组(P<0.05);术后3个月,角膜内皮计数低于术前,总高阶相差高于术前,且同期观察组总高阶像差低于对照组(P<0.05),角膜内皮计数高于对照组,但差异无统计学意义(P>0.05);术后1年,观察组的脱镜率、视物满意度和视功能指数均高于对照组,眩光眩晕发生率低于对照组(P<0.05)。结论:Toric IOL植入术与飞秒激光松解联合白内障摘除术均可有效矫正白内障合并低度角膜逆规散光患者的散光情况,但Toric IOL植入术相比能更好地矫正术前角膜散光,提升视觉质量。

IOL Master联合A超在白内障超声乳化联合人工晶状体植入术中的应用

目的探讨IOL Master联合A超在白内障超声乳化联合人工晶状体(IOL)植入术中的应用价值。方法选取于佛山市三水区人民医院接受手术的老年白内障患者80例,按照随机数字表法分为A超组与联合组,每组40例。2组均接受超声乳化联合IOL植入术,A超组于术前使用接触式A超测量眼轴长度(AL)、前房深度(ACD)、晶状体厚度(LT),用Pentacam测量角膜曲率(K);联合组采用IOL Master 5.5联合A超获得上述参数。根据SRK-T公式计算IOL度数。比较2组患者术后3个月的裸眼远视力(UDVA)、裸眼中视力(UIVA)、裸眼近视力(UNVA)、屈光误差,并采用IOL植入术后视觉评估问卷调查患者术后情况(脱镜率、不良视觉现象、屈光满意度评分)。结果2组患者术后3个月的UDVA比较差异无统计学意义(P>0.05);联合组术后3个月的UIVA、UNVA均明显高于A超组,差异有统计学意义(P<0.05)。联合组散光1.0~1.5 D患眼的屈光误差及总屈光误差明显低于A超组,差异有统计学意义(P<0.05)。2组患者术后不良视觉现象发生率比较差异无统计学意义(P>0.05)。联合组脱镜率与屈光满意度评分均高于A超组,差异有统计学意义(P<0.05)。结论IOL Master联合A超可通过优势互补最大限度地降低屈光误差,使患者术后获得更理想的裸眼视力,更高的脱镜率与屈光满意度。

炎性因子在糖尿病性白内障IOL术中的检测价值分析

目的探析超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)在糖尿病白内障患者人工晶体植入(IOL)手术中的检测意义。方法选取2016年4月至2018年4月在我院接受诊治的92例糖尿病性白内障患者和88例无糖尿病的白内障患者作为本次研究的观察组和对照组。比较两组患者的基线资料及hs-CRP、IL-6、TNF-α水平。比较视网膜病变(DR)者与非DR者术前术后的hs-CRP、IL-6、TNF-α水平。结果两组患者的基线资料无明显统计学差异(P>0.05)。术前观察组患者的hs-CRP、IL-6、TNF-α水平均明显高于对照组(P<0.01)。DR患者术后第3、7、14d血清hs-CRP、IL-6、TNF-α水平均明显高于非DR者(P<0.05)。结论动态监测炎性因子水平在糖尿病性白内障患者中具有辅助诊断作用,与术后DR的发生可能存在正相关性。

外伤性白内障IOL植入术后继发性近视

目的 分析外伤性白内障IOL植入术后继发性近视发生的情况。方法 观察 4例外伤性白内障IOL植入术后发生继发性近视的原发性损伤、治疗经过及矫正结果。结果 受伤年龄 1 1～ 31岁 ,受伤前均系正视眼 ,白内障摘出及IOL植入术都在受伤后 2月内施行 ,IOL屈光度合适 ,继发性近视的形成 /发展于术后 3月以上甚至 3年或者更长的时间。结论 外伤性白内障IOL植入术后继发性近视的发生可能与眼穿孔伤造成伤眼角膜散光、角膜疤痕、晶状体浑浊、玻璃体浑浊等多种形觉剥夺因素有关。强调对眼外伤尤其严重性眼外伤者长期随访的重要性 ,及时去除各种形觉剥夺因素 ,以恢复和保持伤眼的有用视力。

白内障超声乳化联合IOL植入术后角膜水肿的研究进展

角膜水肿是白内障超声乳化联合人工晶状体(IOL)植入术后常见的并发症,是由于各种原因造成的角膜内皮细胞损伤所引起,导致患者视物模糊、视力下降,长期不退可造成角膜失代偿甚至失明。因此,角膜水肿的预防与合理治疗十分重要。根据具体临床状况,可采用药物、接触镜、手术等方法进行治疗。本文就白内障超声乳化联合人工晶状体植入术后角膜水肿的发病机制、致病因素及其防治的研究进展作一综述。

不同黏弹剂对白内障超乳摘除及折叠IOL植入术后患者角膜内皮的影响

目的:分析双重黏弹剂DisCoVisc和透明质酸钠两种黏弹剂对白内障超声乳化摘除及折叠人工晶状体(IOL)植入术患者术后角膜内皮的影响。方法:选取2017-06/2019-12在荆门市爱尔眼科医院就诊的白内障患者247例285眼,按随机数字表法分DisCoVisc组(123例141眼)与透明质酸钠组(124例144眼)。两组均接受超声乳化摘除及折叠IOL植入术,DisCoVisc组术中使用DisCoVisc作为黏弹剂,透明质酸钠组术中使用1.7%透明质酸钠作为黏弹剂;比较两组术中超声乳化时间(UST)、累计释放能量(CDE)、植入IOL后抽吸黏弹剂的时间;术后1d, 1wk, 1、3mo时角膜水肿情况,术前、术后3mo时的角膜内皮细胞密度(ECD)及ECD损失率,角膜内皮细胞面积变异系数(CV)、角膜六角形内皮细胞比率(6A);术前,术后1d, 1wk, 1mo时的眼压、裸眼视力≥0.5的患者比例及中央角膜厚度(CCT)值。结果:两组UST、CDE、黏弹剂抽吸时间均无差异(P>0.05);两组术后1d时角膜水肿率无差异(P>0.05),术后1wk时角膜水肿均消失;术后3mo时DisCoVisc组ECD损失率显著低于透明质酸钠组(P<0.05);两组术前,术后1d, 1wk, 1mo时的眼压水平、裸眼视力≥0.5比例、CCT值均无差异(P>0.05)。结论:Emery-Little晶状体核硬度分级Ⅱ~Ⅲ级患者超声乳化摘除联合折叠IOL植入术中使用DisCoVisc作为黏弹剂对角膜内皮的保护作用更好。

超声乳化联合IOL植入术治疗原发性闭角型青光眼合并白内障疗效观察

目的探讨白内障超声乳化联合人工晶状体(IOL)植入术治疗原发性闭角型青光眼合并白内障的疗效,为患者诊疗提供依据。方法回顾性分析2018年1月至2020年3月高州市中医院眼科收治的53例原发性闭角型青光眼合并白内障患者的临床资料。根据治疗方法不同分组,其中以25例行周边虹膜切除手术治疗者为对照组,28例行超声乳化联合IOL植入术治疗者为观察组。术后3个月比较两组患者的治疗效果和术前、术后3个月的视力、眼压、前房深度、生活质量[采用视功能指数量表(VF-14)评估]以及并发症发生情况。结果观察组患者的治疗总成功率为92.86%,明显高于对照组的72.00%,差异有统计学意义(P<0.05);术后3个月,两组患者的视力、前房深度均明显升高,且观察组分别为(0.78±0.09)、(3.98±0.34) mm,明显高于对照组的(0.64±0.10)、(2.65±0.41) mm,眼压明显降低,观察组为(14.12±2.10) mm Hg,明显低于对照组的(19.24±2.62) mmHg,差异均有统计学意义(P<0.05);术后3个月,两组患者的生活质量评分均明显升高,观察组为(45.17±4.01)分,明显高于对照组的(38.69±4.22)分,差异有统计学意义(P<0.05);观察组患者的并发症发生率为7.14%,明显低于对照组的28.00%,差异有统计学意义(P<0.05)。结论超声乳化联合IOL植入术治疗原发性闭角型青光眼合并白内障可有效改善患者的视力,降低眼压及并发症,提高生活质量,临床治疗效果好。

2型糖尿病白内障行超声乳化联合IOL植入术的安全性分析

目的:探讨超声乳化吸除联合人工晶状体植入对2型糖尿病白内障患者视力影响和安全性。方法:以我院眼科收治2型糖尿病白内障患者103例112眼为观察对象,并以同期无糖尿病单纯白内障老年患者100例110眼为对照,同一组医务人员进行超声乳化吸除术联合人工晶状体植入术,比较两组近期视力、远期视力及并发症。结果:观察组术后1d;1wk,患者视力较术前均有明显好转(Z=7.63,8.59,P<0.05),对照组术后1d;1wk,患者视力较术前均有明显好转(Z=5.36,4.38,P<0.05);观察组在术后1d;1wk视力较对照组有明显好转(Z=5.48,4.68,P<0.05),观察组最佳矫正视力低于对照组,差异有统计学意义(Z=8.987,P<0.05);观察组在术后1,3mo视力均低于对照组,差异有统计学意义(Z=13.21,11.48,P<0.05)。术后6mo,两组差异无统计学意义(Z=3.141,P>0.05)结论:2型糖尿病白内障患者在血糖控制良好条件下行超声乳化联合人工晶状体植入术能明显改善患者视力,并未发现明显并发症,疗效可靠。

IOL植入术与超声乳化吸除方法结合用于高度近视合并白内障治疗效果

目的探讨IOL植入术结合超声乳化吸除方法 ,用于治疗高度近视合并白内障的效果。方法选择2015年1月~2017年3月在我院眼科运用IOL植入术结合超声乳化吸除的方法,治疗高度的近视并发白内障的98例患者的110枚眼球,对治疗效果进行分析和评价。结果在手术前,矫正视力低于0.05的为58例,0.05~0.3的为52例,未出现0.3以上的,在手术后3个月,矫正视力低于0.05的为9例,0.05~0.3的为39例,0.3~0.5的47例,>0.5的15例,两组数据比较差异有统计学意义(Z=9.666,P=0.001),容易看出,在手术后3个月的视力矫正明显改善,而在手术后3个月,脱残率为56.36%,脱盲率为91.82%,患者进行手术后3个月,对双眼进行裸眼屈光度偏差的检查,其中偏差值高于±1.00D的8例,占构成比的7.27%,偏差值处于±0.50D~±1.00D的31例,占构成比的28.18%,偏差值低于±0.50D的71例,占构成比的64.55%。结论采用IOL植入术与超声乳化吸除方法结合,治疗高度近视合并白内障的手术方法,明显减少了手术后并发症的产生,在临床上显示出了良好的治疗效果,患者在手术后3个月的视力情况改善比较显著,值得在更大的临床范围内进行推广。

PACG合并白内障患者Phaco+IOL植入术联合小梁切除术后并发感染性眼内炎的条件Logistic回归分析

目的:分析原发性闭角型青光眼(PACG)合并白内障患者使用Phaco+IOL植入术联合小梁切除术后并发感染性眼内炎的相关危险因素。方法:回顾性分析2017年10月-2020年10月钟祥市人民医院2 061例接受Phaco+IOL植入术联合小梁切除术治疗的PACG合并白内障患者的临床资料,患眼2 984眼。根据术后是否并发感染性眼内炎分为感染组(72例,105眼)和非感染组(1 989例,2 879眼)。对两组患者临床资料进行单因素比较,选取差异有统计学意义的指标进行条件Logistic回归分析。结果:两组年龄、糖尿病、病房类型、眼外伤、眼部手术史、植入物类型、术后佩戴角膜接触镜情况比较,差异均有统计学意义(P<0.05)。经条件Logistic回归分析可知,高龄、眼外伤、入住日间病房、术后佩戴角膜接触镜均为PACG合并白内障患者术后并发感染性眼内炎的独立危险因素(P<0.05)。结论:PACG合并白内障患者经Phaco+IOL植入术联合小梁切除术后并发感染性眼内炎受高龄、眼外伤、入住日间病房、术后佩戴角膜接触镜等独立因素影响,临床需在手术前后针对以上因素给予预防措施避免患者术后并发感染性眼内炎。

Severe prelenticular membrane formation on the surface of a hydrophilic acrylic intraocular lens after cataract surgery in an eye with an Ahmed valve implant

【正】Dear Sir,Iam Yong-Sun Ahn,from the Department of Ophthalmology of St.Vincent Hospital of Suwon,Kyungki-do,South Korea.Cataracts are a common problem in eyes with a glaucoma drainage device(GDD),because tube shunt surgery increases the incidence and progression of cataracts[1].An Ahmed valve,the most commonly inserted GDD,is composed of a silicone tube connected to a flat plate sewn to the sclera,and aqueous humor flows from the