Клинический случай замены помутневшей интраокулярной линзы на авитреальном глазу

Abstract

Purpose. Using a clinical example, to analyze the possible causes of opacity of the Hydro-4 Aspheric IOL (Rumex, Great Britain). Materials and methods. Patient K., 32 years old, underwent the surgery for tractional retinal detachment in both eyes, which arose against the background of proliferative diabetic retinopathy of the retina. A history of type 1 diabetes mellitus from the age of 9. The visual acuity of both eyes before surgery was 0.03 n/k. Microinvasive (25G) vitrectomy with silicone oil tamponade of the vitreous cavity was performed. The second stage of surgical treatment is the removal of silicone oil from the vitreous cavity and phacoemulsification of cataract with partial excision of the posterior lens capsule with IOL implantation into the capsule bag of both eyes. A Hydro-4 Aspheric IOL (Rumex, UK) was implanted in the right eye, and Aspira-aAy (HumanOptic AG, Germany) – in the left one. After 3 months, on examination, attention was drawn to the diffuse opacity of the IOL of the right eye. The visual acuity was 0.01 n/k. The IOL replacement technique was as follows. Viscoelastic was injected into the anterior chamber and into the capsule bag through corneal paracentesis at 10 and 2 o'clock. The lens was dislocated into the anterior chamber and cut in half with vitreal scissors. The cut parts of the IOL were removed through a 2.2 mm tunnel at 12 o'clock. The Tecnis lens (AMO, USA) was chosen for implantation. Results and discussion. There was an increase in uncorrected visual acuity up to 0.4. There were no intra- and postoperative complications such as hemorrhagic, inflammatory, and also any from the cornea. The question remains open why, with the same tactics of the first two stages of surgical treatment of both eyes and implantation of lenses made of hydrophilic acrylic, only one IOL became cloudy. Accounting for the materials from which the IOL is made, which lens model is better to prefer to this day remains an urgent and unresolved problem for ophthalmic surgeons. Conclusion. The presence of a concomitant diabetes mellitus in the patient could influence the development of opacification of the hydrophilic acrylic IOL. Key words: IOL opacity, hydrophilic acrylic, IOL explantation, avitria.