Foldable Silicone Research Articles

A 3D in vitro model for assessing the influence of intraocular lens: Posterior lens capsule interactions on lens epithelial cell responses

Posterior Capsule Opacification (PCO), the most frequent complication of cataract surgery, is caused by the infiltration and proliferation of lens epithelial cells (LECs) at the interface between the intraocular lens (IOL) and posterior lens capsule (PLC). According to the “no space, no cells, no PCO” theory, high affinity (or adhesion force) between the IOL and PLC would decrease the IOL: PLC interface space, hinder LEC migration, and thus reduce PCO formation. To test this hypothesis, an in vitro hemisphere-shaped simulated PLC (sPLC) was made to mimic the human IOL: PLC physical interactions and to assess their influence on LEC responses. Three commercially available IOLs with different affinities/adhesion forces toward the sPLC, including Acrylic foldable IOL, Silicone IOL, and PMMA IOL, were used in this investigation. Using the system, the physical interactions between IOLs and sPLC were quantified by measuring the adhesion force and interface space using an adhesion force apparatus and Optical Coherence Tomography, respectively. Our data shows that high adhesion force and tight binding between IOL and sPLC contribute to a small interface space (or “no space”). By introducing LECs into the in vitro system, we found that, with small interface space, among all IOLs, acrylic foldable IOLs permitted the least extent of LEC infiltration, proliferation, and differentiation (or “no cells”). Further statistical analyses using clinical data revealed that weak LEC responses are associated with low clinical PCO incidence rates (or “no PCO”). The findings support that the in vitro system could simulate IOL: PLC interplays and predict IOLs’ PCO potential in support of the “no space, no cells, no PCO” hypothesis.

Descemet Stripping Endothelial Keratoplasty in Patients With a Custom Foldable Silicone Artificial Iris: Safety and Efficacy Outcomes.

To assess outcomes of Descemet stripping endothelial keratoplasty (DSEK) in eyes with custom artificial iris (CAI) implantation. This is a retrospective, interventional, consecutive, surgical case series of patients who underwent DSEK after CAI implantation between 2010 and 2021 at 2 referral centers. Primary safety measures were loss of corrected distance visual acuity (CDVA), increase in intraocular pressure (IOP), development or progression of glaucoma, and intraoperative and postoperative complications. Efficacy measures were graft survival at year 1 and improvement in cosmesis at postoperative month 3. In general, measures were compared between baseline and postoperative year 1 while any complication was reported for the full follow-up period. Thirty-nine eyes of 39 patients were identified. 64.1% of eyes had acquired aniridia from trauma. The mean follow-up interval was 27.7 months (range 12.2-117.4). Median CDVA improved from logMAR 1.0 to 0.7 at year 1 (P = 0.0047). At the final follow-up, permanent loss of CDVA occurred in 25.6% of eyes, of which 90% was due to glaucoma. The most common postoperative complication was IOP elevation (66.7% of eyes). Graft survival at postoperative year 1 was 82.0% (95% confidence interval, 66.3-91.4). Secondary graft failure occurred in 28.2% of eyes at a mean duration of 39.7 months (SD 27.9 months) after DSEK. Cosmesis improved among 87.2% of eyes at postoperative month 3. DSEK is an effective procedure for addressing corneal edema in eyes with a CAI, but a majority develop elevated IOP and graft survival is shorter than in eyes without a CAI.

The usage of CustomFlex iris prosthesis for uveitis-induced iris defects

Iris defects can cause glare and poor cosmesis that affects a patient’s quality of life. These defects may be caused by congenital aetiologies such as aniridia or acquired ones such as trauma and intraocular surgeries. Iris prostheses, like the CustomFlex Artificial iris by HumanOptics, were created to address these symptoms. The CustomFlex device is a stand-alone thin and foldable silicone coloured implant that could be placed in either the capsular bag or the sulcus. Because the majority of iris defects requiring prosthetic use was secondary to trauma, congenital aniridia and intraocular surgeries, our case report aims to describe usage of the CustomFlex in a patient with iris defects secondary to uveitis. Our patient presented with photophobia caused by bilateral diffuse iris atrophy with a history of herpes zoster ophthalmicus and underwent simultaneous iris prosthesis and intraocular lens implantation. The procedure improved his vision while reducing photophobia and glare. This case report shows how endocapsular implantation of the CustomFlex artificial iris, along with cataract surgery, is feasible for patients with uveitis related iris defects.

Flexible solar cells based on foldable silicon wafers with blunted edges

Flexible solar cells have a lot of market potential for application in photovoltaics integrated into buildings and wearable electronics because they are lightweight, shockproof and self-powered. Silicon solar cells have been successfully used in large power plants. However, despite the efforts made for more than 50 years, there has been no notable progress in the development of flexible silicon solar cells because of their rigidity1–4. Here we provide a strategy for fabricating large-scale, foldable silicon wafers and manufacturing flexible solar cells. A textured crystalline silicon wafer always starts to crack at the sharp channels between surface pyramids in the marginal region of the wafer. This fact enabled us to improve the flexibility of silicon wafers by blunting the pyramidal structure in the marginal regions. This edge-blunting technique enables commercial production of large-scale (>240 cm2), high-efficiency (>24%) silicon solar cells that can be rolled similarly to a sheet of paper. The cells retain 100% of their power conversion efficiency after 1,000 side-to-side bending cycles. After being assembled into large (>10,000 cm2) flexible modules, these cells retain 99.62% of their power after thermal cycling between −70 °C and 85 °C for 120 h. Furthermore, they retain 96.03% of their power after 20 min of exposure to air flow when attached to a soft gasbag, which models wind blowing during a violent storm.

Sutured Custom Foldable Silicone Artificial Iris Implantation Combined With Intraocular Lens Implantation and Penetrating Keratoplasty: Safety and Efficacy Outcomes.

Purpose:To assess safety and efficacy outcomes of sutured custom silicone artificial iris and intraocular lens implantation combined with penetrating keratoplasty (triple procedure).Methods:Prospective consecutive surgical case series of patients who underwent the triple procedure between 2010 and 2019 at Stein Eye Institute, UCLA, followed up for 1 year minimum. Safety outcomes were changes from preoperative to last follow-up in corrected distance visual acuity (CDVA), endothelial cell count, intraocular pressure (IOP), and postoperative complications. Efficacy outcomes included changes in subjective glare (none to severe), cosmetic appearance (worse to very much improved), and visual function as assessed by the Visual Function Questionnaire-25 at 1-year follow-up.Results:Among 82 eyes implanted with an artificial iris, 14 eyes (17.1%) underwent the triple procedure. The median follow-up was 18.1 months (range 12.0–54.9 months). The median CDVA improved from 2.0 log of minimum angle of resolution (logMAR) (range 0.9–2.3 logMAR) to 0.7 logMAR (range 0.2–2.6 logMAR) (P = 0.02). Average endothelial cell count decreased 57.6% (P < 0.01). Six eyes (42.9%) experienced IOP elevations, 13 eyes (92.3%) developed iritis, and 11 eyes (78.6%) underwent secondary surgery. Graft rejection or secondary graft failure occurred in 7 eyes each (50.0%). Cosmesis improved in 12 eyes (85.7%; P < 0.01). The Visual Function Questionnaire-25 score improved from 72 to 77 (P < 0.01). Glare symptoms did not change significantly.Conclusions:The triple procedure was effective at improving CDVA, cosmesis, and quality of life; however, it was associated with frequent postoperative complications, of which iritis, IOP elevation, and secondary graft failure were the most common.

Safety and efficacy of custom foldable silicone artificial iris implantation: prospective compassionate-use case series.

To assess the preliminary safety and efficacy of custom silicone artificial iris implantation. Stein Eye Institute. Prospective consecutive case series. Medical records of patients implanted with the artificial iris were reviewed and followed for 1 year. Safety measures included corrected distance visual acuity (CDVA), intraocular pressure (IOP), endothelial cell count (ECC), surgical complications, secondary interventions, and adverse events (AEs). Efficacy measures included CDVA with glare, subjective daytime and nighttime glare graded from 0 to 10 (very significant), and subjective cosmetic appearance graded from 0 to 10 (very satisfied). Twenty eyes (19 patients) were implanted. Safety data were mixed. CDVA improved in 13 eyes and worsened in 6. ECC decreased from 1918 ± 870 to 1405 ± 705 cells/mm (P = .02). Eight eyes experienced postoperative complications. There were 4 IOP elevations, 2 corneal decompensations, 1 case of cystoid macular edema, and 1 device dislocation. Four eyes underwent secondary surgical interventions including 2 AEs (1 glaucoma surgery and 1 device dislocation). Efficacy outcomes were excellent. CDVA with glare improved from 1.5 ± 0.6 to 0.7 ± 0.8 logarithm of the minimum angle of resolution (P < .01). Mean subjective daytime glare decreased from 8.9 ± 1.8 to 2.7 ± 2.6 (P < .01) and nighttime glare decreased from 7.9 ± 1.8 to 2.5 ± 2.7 (P < .01). Mean cosmesis improved from 2.2 ± 1.6 to 8.8 ± 2.1 (P < .01). Custom artificial iris implantation was moderately risky but very effective at reducing light and glare sensitivity and in improving ocular cosmesis.

Disruptive Innovation and Refractive IOLs: How the Game Will Change With Adjustable IOLs.

The light-adjustable lens is the first Food and Drug Administration (FDA)-approved product from an entirely new category of intraocular lenses (IOLs). The 3-piece foldable silicone light-adjustable lens is implanted through a small incision after phacoemulsification. A slit-lamp-based digital light delivery device is used to adjust and then lock-in the IOL power during the first postoperative month. Up to 4.5 diopters (D) of cylindrical or spherical adjustment can be achieved. This should offer significant advantages in difficult IOL power calculation cases, such as postrefractive eyes. In addition to achieving better refractive accuracy, an adjustable IOL will now allow patients to test and elect a different refractive target postoperatively. This paradigm shift will change how cataract patients choose their refractive objectives, and how ophthalmologists will be able to achieve them. For example, adjustable IOLs may increase the popularity of pseudophakic monovision and bilateral same-day sequential surgery. For those electing adjustable IOL, preoperative patient counseling will change and certain pre- and intraoperative technologies, such as intraoperative aberrometry and digital astigmatic axis marking, would become superfluous.

Effect of selectively passivated layer on foldable low temperature polycrystalline silicon thin film transistor characteristics under dynamic mechanical stress

For the next generation display, foldable display is one of the attractive candidates. However, the degradation effects due to the mechanical stress on the device are unavoidable. A strain due to the mechanical stress generates cracks on the thin film transistors (TFTs). In this case, if the methodology guiding cracks is applied in the fabrication process, the device reliability can be enhanced. In this paper, a crack guided layer followed by the device fabrication process is deposited on p-type low temperature polycrystalline silicon (LTPS) TFT. Statistical analysis is also used to analyze the crack guided layer effects. To apply a strain on the foldable LTPS TFTS, 5000cycles of dynamic mechanical stress with tensile and perpendicular directions were applied with 2-mm bending radius. Based on the results, TFT reliability can be enhanced by controlled the crack position using the crack-guided passivation layer.

Crack-guided effect on dynamic mechanical stress for foldable low temperature polycrystalline silicon thin film transistors

In the thin film transistors (TFTs) device research for foldable display, the degradation effect by the mechanical stress is crucial. Here, the crack position is critical for TFT reliability. However, it is difficult to characterize the crack position due to the random generation of the crack by mechanical stress. In this paper, the crack-guided low temperature polycrystalline silicon (LTPS) TFT test structures are fabricated and the crack-guided effects on mechanical stress of the tested TFT structure are analyzed. To strain on the foldable LTPS TFTs, 50,000cycles of tensile and parallel direction dynamic mechanical stresses were applied with 2.5-mm bending radius. Based on the results, the generating crack position can be guided and controlled and also TFT reliability for foldable display can be enhanced.

Design and fabrication of a foldable 3D silicon based package for solid state lighting applications

Miniaturization of solid state lighting (SSL) luminaires as well as reduction of packaging and assembly costs are of prime interest for the SSL lighting industry. A novel silicon based LED package for lighting applications is presented in this paper. The proposed design consists of 5 rigid Si tiles connected by flexible polyimide hinges with embedded interconnects (ICs). Electrical, optical and thermal characteristics were taken into consideration during design. The fabrication process involved polyimide (PI) application and patterning, aluminium interconnect integration in the flexible hinge, LED reflector cavity formation and metalization followed by through wafer DRIE etching for chip formation and release. A method to connect chip front to backside without TSVs was also integrated into the process. Post-fabrication wafer level assembly included LED mounting and wirebond, phosphor-based colour conversion and silicone encapsulation. The package formation was finalized by vacuum assisted wrapping around an assembly structure to form a 3D geometry, which is beneficial for omnidirectional lighting. Bending tests were performed on the flexible ICs and optical performance at different temperatures was evaluated. It is suggested that 3D packages can be expanded to platforms for miniaturized luminaire applications by combining monolithic silicon integration and system-in-package (SiP) technologies.

Towards neuromorphic electronics: Memristors on foldable silicon fabric

The advantages associated with neuromorphic computation are rich areas of complex research. We address the fabrication challenge of building neuromorphic devices on structurally foldable platform with high integration density. We present a CMOS compatible fabrication process to demonstrate for the first time memristive devices fabricated on bulk monocrystalline silicon (100) which is next transformed into a flexible thin sheet of silicon fabric with all the pre-fabricated devices. This process preserves the ultra-high integration density advantage unachievable on other flexible substrates. In addition, the memristive devices are of the size of a motor neuron and the flexible/folded architectural form factor is critical to match brain cortex׳s folded pattern for ultra-compact design.

Biocompatibility and retinal support of a foldable capsular vitreous body injected with saline or silicone oil implanted in rabbit eyes

The aim of this study was to evaluate over a 180-day period the biocompatibility and retinal support of a foldable capsular vitreous body injected with either saline or silicone oil implanted in rabbit eyes. A standard three-port pars plana vitrectomy was performed, and foldable capsular vitreous bodies were implanted into the vitreous cavity of rabbit eyes (n = 18). Silicone oil tamponade was used as the control group (n = 5). Of the foldable capsular vitreous body-implanted eyes, either saline (n = 9) or silicone oil (n = 9) was injected into the foldable capsular vitreous body to support the retina. The treated eyes were examined using a slit lamp with a non-contact slit-lamp lens, a tonopen, a non-contact specular microscope and a B-scan ultrasound during the 180-day implantation period. A histological examination was performed at 90 and 180 days. During the 180-day implantation period, no significant corneal keratopathy or intraocular inflammation was noted, and the intraocular pressure (IOP) and corneal endothelial numbers remained steady among the three groups. B-scan ultrasonography showed a smoothly increased echogenicity in front of the retina in group of foldable capsular vitreous bodies injected with saline. Gross examination showed that the foldable capsular vitreous bodies injected with saline or silicone oil smoothly supported the retina. The saline or silicone oil inside the foldable capsular vitreous body was homogeneous, transparent and filled the foldable capsular vitreous body. Histological examination showed no obvious abnormality of the cornea, ciliary body or retina in the foldable capsular vitreous body-implanted eyes. These results suggest that foldable capsular vitreous bodies injected with either saline or silicone oil showed good biocompatibility and retinal support in rabbit eyes over a 180-day implantation time.

Four-year experience with a silicone refractive multifocal intraocular lens

To assess the long-term outcomes after implantation of a foldable silicone refractive multifocal intraocular lens (IOL). Private practice, Osaka, Japan. This retrospective study evaluated eyes that had implantation of an Array SA40N silicone refractive multifocal IOL with a follow-up of up to 4 years. Outcome measures were refraction, corneal astigmatism, uncorrected (UDVA) and corrected (CDVA) distance visual acuities, uncorrected (UNVA) and corrected (CNVA) near visual acuities, incidence of glare and halos, patient satisfaction, time to neodymium:YAG (Nd:YAG) laser capsulotomy, and spectacle dependence. The study comprised 41 patients (72 eyes) with a mean age of 48.7 years +/- 13.4 (SD) (range 18 to 71 years) and a mean scotopic pupil size of 5.7 +/- 1.0 mm (range 4.0 to 8.5 mm). The refraction and corneal astigmatism were stable throughout the 4-year follow-up. The mean acuity values 1 month postoperatively were as follows: UDVA, 0.06 logMAR; CDVA, 0.08 logMAR; UNVA, 0.24 logMAR; CNVA, 0.04 logMAR. The change at 4 years was not significant for any visual acuity (P>.64). Patient satisfaction with near vision decreased at 2 years (P = .054). An Nd:YAG laser capsulotomy was performed in 48 eyes (66.7%) a mean 21.7 +/- 16.3 months postoperatively. The silicone refractive multifocal IOL provided good and stable distance and near visual acuities over the 4-year follow-up, even though it was anticipated that slight posterior capsule opacification would affect near vision. No author has a financial or proprietary interest in any material or method mentioned.

Viscoanaesthesia in cataract surgery: a prospective, randomized clinical trial

We aimed to compare viscoanaesthesia (VisThesia) with intracameral lidocaine in cataract surgery carried out under topical anaesthesia. In this prospective study 98 patients were randomly assigned to receive VisThesia (group 1, n = 49) or 0.5 cc of 1% unpreserved lidocaine (group 2, n = 49). All surgery was carried out by one surgeon using clear corneal technique. Pachymetry, the status of the cornea and anterior chamber, and intraocular pressure (IOP) were checked pre- and postoperatively. Mean pain scores were 0.12 (maximum: 3) in group 1 and 0.37 in group 2; the difference between the groups was not statistically significant (95% confidence interval [CI] 0.003-0.487; p = 0.05). A total of 48 patients in group 1 (98%) and 49 in group 2 (100%) reported no discomfort or only mild discomfort. No significant differences in flare and cells in the anterior chamber or IOP were found between the two study groups. There was a significantly greater frequency of corneal oedema in group 1 (p = 0.001). Postoperative central corneal thickness values were also significantly higher in group 1 (95% CI 11.64-57.24; p = 0.003). Results suggest that viscoanaesthesia provides a level of comfort during cataract surgery under topical anaesthesia similar to that facilitated by intracameral lidocaine. However, patients who are given viscoanaesthesia may have increased risk for postoperative corneal oedema.

Nd:YAG laser capsulotomy rates following implantation of square-edged intraocular lenses: polymethyl methacrylate versus silicone versus acrylic

Objective: To study the influence of square-edged intraocular lenses (lOLs) on the development of posterior capsule opacification (PCO) and the requirement for laser capsulotomy. Design: Retrospective study. Participants: Three hundred seventy-seven eyes of 377 patients were included. Methods: All these patients underwent phacoemulsification and implantation of square polymethyl methacrylate (PMMA) (Aurolab), silicone (Tecnis Z9000), acrylic hydrophobic (AcrySof MA60AC and Sensar Optiedge), or acrylic hydrophilic (Akreos Adapt) lOLs with a minimum of 2 years’ follow-up. Only those cases in which Nd:YAG laser capsulotomy had been performed for visually significant PCO were evaluated. Results: Three hundred seventy-seven eyes of 377 patients were included in the study. Follow-up duration ranged from 24 to 54 (mean 40.27, SD 8.42) months. The incidence of PCO requiring Nd:YAG laser capsulotomy was found to be significantly less in the silicone lens group: 1.4% as compared with an incidence of 11.7% in the PMMA lens group (p = 0.018). In the square-edged acrylic group, visually significant PCO requiring Nd:YAG laser capsulotomy was observed in 3.6%, 4.8%, and 6.8% of eyes implanted with AcrySof MA60AC, Sensar Optiedge, and Akreos Adapt lOLs, respectively. In 5 of the 7 eyes (71.4%) exhibiting PCO in the PMMA group, the condition developed within the first 6 months. In the silicone and acrylic group, development of PCO was delayed. Conclusions: The rate of visually significant PCO as well as the need for Nd:YAG laser capsulotomy is influenced by IOL biomaterial in addition to square edge. It is significantly delayed with square-edged foldable acrylic and silicone lOLs compared with square-edged PMMA IOLs.

Implantation einer faltbaren, iris-fixierten, phaken Intraokularlinse für die Korrektur von Kurzsichtigkeit

The aim of this study was to evaluate the predictability and visual outcome of a foldable silicone iris-fixated phakic intraocular lens (Artiflex, Ophtec) for the correction of moderate to high myopia. A retrospective cohort study with 34 eyes of 20 patients was undertaken. All patients underwent similar lens implantation with iris enclavation. The follow-up was 6 months. At the final visit, 81% of eyes were within 0.5 D of the target spherical equivalent. Intraocular lenses with -12.0 to -14.5 D power showed a mean overcorrection of +0.81 D. The highest mean overcorrection of +1.45 D was shown by the Artiflex lenses with -14.5 D of power. The postoperative refraction remained stable, but the postoperative uncorrected and best-corrected visual acuity increased over time. 56% of eyes gained 1 or more Snellen lines of best-corrected visual acuity; one eye lost one line. No intraoperative complication was noticed. Two eyes showed prolonged intraocular inflammation. The implantation of the phakic Artiflex intraocular lens was safe and showed a good predictability and safety for the correction of moderate to high myopia. It is an efficient alternative for laser in-situ keratomileusis, especially in high myopia, leading to a stable refraction one month postoperatively.

Capsular bag refilling using a new accommodating intraocular lens

To describe a capsular bag refilling procedure using an accommodating intraocular lens (IOL). Jinshikai Medical Foundation Nishi Eye Hospital, Osaka, Japan. A disk-shaped anterior foldable silicone accommodating IOL that serves as an optical device and as a mechanical device to prevent leakage of the injected silicone polymers was developed. The IOL optic is 6.0 mm and the overall diameter, 9.0 mm. After a 3.5 to 4.0 mm continuous curvilinear capsulorhexis (PCCC) is created, phacoemulsification and aspiration are performed in the usual manner. Then, a posteriorly placed accommodating IOL with sharp edges is implanted in the capsular bag to prevent posterior capsule opacification (PCO) and leakage of the injected silicone polymer. A PCCC is an option at this point. Then, an anterior accommodating IOL is piggybacked over the existing IOL and silicone polymers are injected between the 2 IOLs. Experiments in numerous pig cadaver eyes and in 10 rabbit eyes showed minimal to no silicone leakage. In cases in which a PCCC was not created, 2 eyes had no PCO and 3 showed slight to moderate PCO. None of the 5 eyes with a PCCC had no PCO 5 to 8 weeks after surgery within the PCCC. The procedure in rabbit eyes overcame 2 problems of lens-refilling techniques: leakage of the injectable silicone polymer and capsule opacification.

Position of rigid and foldable iris-fixated myopic phakic intraocular lenses evaluated by Scheimpflug photography

To evaluate the postoperative intraocular positional stability of 1 rigid poly(methyl methacrylate) (PMMA) phakic intraocular lens (pIOL) model and 2 foldable polysilicone-PMMA iris-fixated pIOL models. Department of Ophthalmology, Johann Wolfgang Goethe-University Frankfurt am Main, Germany. One of 3 iris-fixated pIOL models (Artisan, Artiflex I, and Artiflex II, Ophtec BV) was implanted in 45 eyes of 26 patients with myopia or myopic astigmatism. The central distance between the pIOL and corneal endothelium and between the pIOL and anterior surface of the crystalline lens was evaluated using Scheimpflug photography 6 and 12 months after surgery. The mean preoperative spherical equivalent was -9.32 diopters +/- 1.78 (SD) (range -6.5 to -13.5 D). Each IOL model was implanted in 15 eyes. The median distance from the central corneal endothelium to the anterior surface of the pIOL at 6 months and 12 months was 2.65 mm and 2.64 mm, respectively, in the Artisan group, 2.47 mm and 2.50 mm, respectively, in the Artiflex I group, and 2.48 mm and 2.52 mm, respectively, in the Artiflex II group. The median distance between the posterior surface of the pIOL and the anterior surface of the crystalline lens at 6 months and 12 months was 0.40 mm and 0.48 mm, respectively, in the Artisan group, 0.53 mm and 0.55 mm, respectively, in the Artiflex I group, and 0.68 mm and 0.66 mm, respectively, in the Artiflex II group. At 12 months, the distance between the pIOL and crystalline lens was statistically significantly greater in the Artiflex II group than in the Artisan group (P<.01). The intraocular position of rigid pIOLs and foldable silicone iris-supported pIOLs showed a difference between the 3 pIOL models in space to the crystalline lens and the corneal endothelium, which may affect long-term results in terms of IOL interaction with surrounding tissue.

Comparison of PMMA, silicone and acrylic intraocular lenses in combined phacoemulsification and trabeculectomy

目的 比较青光眼白内障联合术中植入不同材料人工晶状体(IOL)的临床效果.方法 回顾性分析行青光眼白内障联合术70例(76眼),其中植入PMMA IOL 30例(36眼),硅胶IOL 23例(23眼),丙烯酸酯折叠IOL 17例(17眼).对治疗效果进行评价,平均随访期限为10.5月.结果 3组间术后眼压和最佳矫正视力差异无统计学意义.前房纤维素样渗出物和IOL表面沉积物发生率,硅胶组高于PMMA组和丙烯酸酯组,但差异无统计学意义.后发障发生率,丙烯酸酯组和硅胶组显著低于PMMA组,差异有统计学意义.结论 行青光眼白内障联合术植入PMMA,硅胶与丙烯酸酯IOL在降眼压和提高视力方面具有相似的效果.但硅胶IOL的前房纤维素样渗出物及IOL表面沉积物发生率高于PMMA和丙烯酸酯IOL.丙烯酸酯和硅胶IOL的后发障发生率低于PMMA IOL。

Posterior synechias following implantation of a foldable silicone iris-fixated phakic intraocular lens for the correction of myopia

A 45-year-old white woman with unilateral high myopia had uneventful implantation of a -9.0 diopter, foldable, iris-fixated Artiflex I anterior chamber phakic intraocular lens (pIOL) (Ophtec B.V.) in the right eye. Despite application of topical antibiotic and steroid agents for 4 weeks after surgery, iris pigment dispersion developed on the anterior surface of the crystalline lens. Two weeks later, the iris dispersion increased and posterior synechias developed from the iris to the crystalline lens next to the pIOL haptic at the 3 o'clock position. Consequently, pIOL re-enclavation was performed without surgically removing the posterior synechias. Initial and interim mydriatic and steroid eyedrops were administered 4 times a day. Regular follow-up examinations after re-enclavation (at 2, 3, 6, 12, and 24 months) confirmed a stable pIOL position by Scheimpflug photography. Two years after implantation, posterior synechias persisted at the 3 o'clock position, with iris dispersion on the crystalline lens and the posterior side of the pIOL, but with no signs of anterior chamber inflammation and no visual acuity loss.