CATARACT SURGERY AND INTRAOCULAR LENS IMPLANTATION IN ANTERIOR MEGALOPHTHALMOS -- A CASE REPORT

眼前部巨大症的白內障摘除及人工水晶體植入－－病例報告

張婺婷(Wu-Ting Chang) ； 林惠真(Hui-Chen Lin)

《中華民國眼科醫學會雜誌》 53卷2期 (2014/10) Pp. 159-165

https://doi.org/10.30048/ACTASOS.201410_53(2).0010

摘要

目的：報告對罕見的眼前部巨大症施行白內障摘除及植入人工水晶體可能發生的特殊狀況，與水晶體度數的選擇。方法：病例報告。結果：病人在術後很快得到良好的視力。以Holladay 1 formula計算人工水晶體度數，右眼有正零點六二屈光度的誤差，左眼幾乎沒有誤差。追蹤兩年中，即使執行後囊切除，人工水晶體並未發生位移。左眼發現視網膜裂孔並以局部雷射治療。結論：建議術前先以超音波生物顯微鏡評估囊袋。術中宜使用較低的超音波能量，並小心地移除白內障皮層。Holladay 2 formula較能準確計算水晶體的度數。如果囊袋穩定，可將人工水晶體置入囊袋中；如果囊袋鬆脫，建議使用囊袋張力環再將人工水晶體置入囊袋中，或者使用固定在虹彩的人工水晶體。術後宜多留意玻璃體視網膜的併發症。

並列摘要

Purpose: To report the outcome of cataract surgery in both eyes of a patient with anterior megalophthalmos. Methods: A case report. Results: The patient’s visual acuity of both eyes recovered soon and well after operation. Using Holladay 1 formula to measure the power of intraocular lens yielded satisfactory results. The centration of intraocular lens remained good, even though YAG-capsulotomy had been performed. A retinal tear was found in the left eye, and then treated with focal photocoagulation. Conclusion: Cataract surgery in anterior megalophthalmos is often challenging. Using ultrasound biomicroscopy (UBM) to evaluate the capsule would be appropriate. A low level of phacoemulsification power and cautious I/A (irrigation/aspiration) are important. Holladay 1 formula is suitable for calculating IOL power. If there is no zonular dialysis, standard IOL can be inserted into the capsular bag. Otherwise, capsular tension ring and Iris-clip IOL should be considered. Vitreoretinal complications should be kept in mind.

並列關鍵字

Anterior megalophthalmos ； cataract surgery