中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2010年
8期
697-701
,共5页
杨国渊%刘谊%刘陇黔%张军军
楊國淵%劉誼%劉隴黔%張軍軍
양국연%류의%류롱검%장군군
晶体,人工%手术后并发症%水凝胶类
晶體,人工%手術後併髮癥%水凝膠類
정체,인공%수술후병발증%수응효류
Lenses,intraocular%Postoperative complications%Hydrogels
目的 实验室及临床观察分析超声乳化白内障吸除联合水凝胶折叠式人工晶状体(IOL)植入术后远期发生混浊的原因.方法 对4例(4只眼)超声乳化白内障吸除联合水凝胶折叠式IOL植入术后12.0～96.0个月(平均33.2个月)发生IOL混浊的患者进行临床观察.其中2例(2只眼)患者行IOL置换术,取出的2枚IOL进行钙特异性茜素红染色病理学检查,用扫描电镜观察混浊IOL表面沉淀物的位置和形态,应用能谱分析法检测沉淀物中的元素成分.结果 裂隙灯显微镜下见白色细小颗粒沉积于IOL前表面.电镜扫描可见有层次感、上下交错,如珊瑚样的颗粒附着于IOL表面.茜素红染色见钙结节和非特异性染色的细胞,能谱分析证实颗粒中含钙和磷元素.结论 水凝胶折叠式IOL表面混浊为颗粒状钙和磷化合物沉淀结晶所致,可能与水凝胶IOL材料易于发生钙磷沉积有关,但确切的发生机制还待更进一步研究.
目的 實驗室及臨床觀察分析超聲乳化白內障吸除聯閤水凝膠摺疊式人工晶狀體(IOL)植入術後遠期髮生混濁的原因.方法 對4例(4隻眼)超聲乳化白內障吸除聯閤水凝膠摺疊式IOL植入術後12.0～96.0箇月(平均33.2箇月)髮生IOL混濁的患者進行臨床觀察.其中2例(2隻眼)患者行IOL置換術,取齣的2枚IOL進行鈣特異性茜素紅染色病理學檢查,用掃描電鏡觀察混濁IOL錶麵沉澱物的位置和形態,應用能譜分析法檢測沉澱物中的元素成分.結果 裂隙燈顯微鏡下見白色細小顆粒沉積于IOL前錶麵.電鏡掃描可見有層次感、上下交錯,如珊瑚樣的顆粒附著于IOL錶麵.茜素紅染色見鈣結節和非特異性染色的細胞,能譜分析證實顆粒中含鈣和燐元素.結論 水凝膠摺疊式IOL錶麵混濁為顆粒狀鈣和燐化閤物沉澱結晶所緻,可能與水凝膠IOL材料易于髮生鈣燐沉積有關,但確切的髮生機製還待更進一步研究.
목적 실험실급림상관찰분석초성유화백내장흡제연합수응효절첩식인공정상체(IOL)식입술후원기발생혼탁적원인.방법 대4례(4지안)초성유화백내장흡제연합수응효절첩식IOL식입술후12.0～96.0개월(평균33.2개월)발생IOL혼탁적환자진행림상관찰.기중2례(2지안)환자행IOL치환술,취출적2매IOL진행개특이성천소홍염색병이학검사,용소묘전경관찰혼탁IOL표면침정물적위치화형태,응용능보분석법검측침정물중적원소성분.결과 렬극등현미경하견백색세소과립침적우IOL전표면.전경소묘가견유층차감、상하교착,여산호양적과립부착우IOL표면.천소홍염색견개결절화비특이성염색적세포,능보분석증실과립중함개화린원소.결론 수응효절첩식IOL표면혼탁위과립상개화린화합물침정결정소치,가능여수응효IOL재료역우발생개린침적유관,단학절적발생궤제환대경진일보연구.
Objective To report clinical, histopathologic, ultrastructural, and chemical features of extracted hydrogel intraocular lens ( IOL, Bausch and Lomb, H60M) from patients who had visual disturbances caused by postoperative opacification of the lens, and discuss the possible causes of this phenomenon. Methods Four cases (4 eyes) were presented after uneventful phacoemulsification and IOL implantation. Two IOLs were removed from 2 patients (2 eyes) with severe decreased visual acuity. Clinical aspects of patients who had opacification of this IOL were observed. Extracted lenses were stained with alizarin red (special stains for calcium) , examined by scanning electron microscope (SEM) and energy dispersive x-ray spectroscopy ( EDS). Results The extracted lenses showed positive staining for alizarin red, indicating that calcium was present on the surface. SEM disclosed coralliform deposits on the superficial substance of the IOL optic. EDS showed that the presence of calcium and phosphorus mainly in the opacification region. Conclusions The surface of the IOL is subject to opacification as a result of calcium phosphate deposition, thereby limiting the patient's visual outcome, and in some cases necessitating the extraction of the lens. These changes may be relavent to the nature of the materials used for the construction of hydrogel IOLs. This important clinical problem requires further studies.
