L O G O 后房型人工晶状体 谢晓兰

人工晶状体的进展 第一代 原始的 Ridley 后房型人工晶状体 第二代 早期前房型人工晶状体 第三代 白内障囊内摘除术后使用过的包括 虹膜囊膜的虹膜支撑型人工晶状体 第四代 从早期前房人工晶状体过渡到新 型前房型人工晶状体 第五代 后房型人工晶状体的过渡和成熟 阶段 第六代 新型人工晶状体

 但是, 作为理想的人 工晶状体应该具备哪 些特征呢 ?

 光学性能高  质量轻  生物相容性好  性能稳定, 无生物降解作用  无刺激, 无致癌性

 ( 一 ) 聚甲基丙烯酸酯 PMMA  ( 二 ) 硅胶 Silicone  ( 三 ) 水凝胶 Hydrogel  ( 四 ) 丙烯酸酯 Acrylic 是 PMMA 的衍生物, 是苯乙基丙烯酸 酯和苯乙基烯酸甲酯大的聚合物。目前是临床上最常用、引起后发障 最少的可折叠人工晶状体材料。

 But,how about the implantation of posterior chamber phakic intraocular lens with a central hole → (Hole ICL) ?

Slit-lamp photograph of the eye after implantation of an implantable collamer lens with a central hole (Hole ICL).

 To prevent pupillary block, this surgical technique unavoidably requires two preoperative laser iridectomies, which are frequently accompanied by some pain; OR intraoperative peripheral iridectomy, which is sometimes complicated by iris haemorrhage, causing surgical difficulties. EVEN

 Implantation of a newly developed Hole ICL offered good results for all measures of safety,efficacy, predictability and stability for the correction of moderate to high myopic errors, even without peripheral iridectomy, suggesting its viability as a surgical option for the treatment of such eyes.

 the RISK of cataract formation,presumably resulting from direct physical contact between the ICL and the crystalline lens or from localised malnutrition causing poor circulation of the aqueous humour.

 A new ICL with an artificial central hole (Hole ICL) in order to overcome these disadvantages is coming up

D convetional with a hole PIOL advantanges ?

safety efficacy predictability less adversity without peripheral iridectomy ICL with a central hole

 evaluated 20 eyes of 20 patients with spherical equivalents of D (mean6SD) who underwent Hole ICL implantation.  Before surgery and at 1 week and 1, 3 and 6 months after surgery,

 Safety outcomes  Effectiveness outcomes  Predictability  Stability  IOP  Endothelial cell density  Secondary surgeries/adverse events

 Hole ICL implantation is safe and effective, and provides predictable and stable refractive results in the correction of moderate to high myopia throughout a 6- month observation period. Moreover, no visionthreatening complications occurred throughout the follow-up period.

 A modified implantable collamer lens (ICL) with a central hole (diameter, 0.36 mm), a “Hole-ICL”, was created to improve aqueous humour circulation ?

L ocations of aqueous humour inflow and outflow. 1: location of aqueous humour outflow; 2: location of aqueous humour inflow

Flow distribution along the long axis of the cross-sectional surface of the Hole-ICL. The length of the arrow corresponds to the flow velocity

Flow distribution along the long axis of the cross-sectional surface for the conventional ICL. The length of the arrow corresponds to the flow velocity

Comparison of flow velocity along the long axis of the crosssectional surface of the Hole-ICL, conventional ICL, and the eye without an ICL. The solid line represents the flow velocity of the Hole-ICL, and the dotted line represents the flow velocity for the conventional ICL

Comparison of flow velocity along the short axis of the crosssectional surface in the Hole-ICL, conventional ICL, and the ey ewithout an ICL

Trajectory analysis in the Hole-ICL (left) and conventional ICL (right). Representative lines are shown The flow distribution between the anterior surface of the crystalline lens and the posterior surface of the Hole-ICL was higher than that between the crystalline lens and the conventional ICL

 The flow distribution between the anterior surface of the crystalline lens and the posterior surface of the Hole-ICL was higher than that between the crystalline lens and the conventional ICL

 Therefore, the circulation of aqueous humour to the anterior surface of the crystalline lens in a Hole-ICL would be higher than that in a conventional ICL.

the importance of aqueous humour circulation anterior chamber depth decrease Your Tesurgical trauma myopia age

 Many surgeons also perform peripheral laser iridotomy (LI) prior to ICL implantation to prevent a pupillary block. LI may cause complications including iritis intraocular haemorrhage,elevation of intraocular pressure, posterior iris synechia, and corneal decompensation, such as bullous keratopathy.

 Using of the Hole-ICL may improve aqueous humour circulation, preventing secondary cataracts and eliminating the need for LI.  ↓↓↓  Hole-ICLs improve the circulation of aqueous humour to the anterior surface of the crystalline lens.

 IN all :  ICL with a hole is a tendency.

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