Refractive alteration of Piggyback intraocular lenses in extremely short eyes

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  • 二枚重ね眼内レンズ挿入をした短眼軸長眼の屈折変化

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Abstract

In cases of cataract surgery for extremely short eyes, difficulties will arise after two posterior chamber lenses implant (Primary Piggyback method): developed hyperopic shift due to the transformation of intraocular lenses (IOLs) placed in the capsular bag and the interlenticular opacification of IOLs. Several cases have already been reported that two IOLs placed in the capsular bag cause the decline of refractive power after the implant. Therefore, one lens in the bag and the other lens in the sulcus is recommended. We report on our two-year-study of refractive alteration in a patient after the implant. Two IOLs were implanted in the bag of her right eye, and one lens in the bag and the other lens in the sulcus of her left eye. The patient was a 64-year-old female suffering from diabetes, Shögren's syndrome, rheumatism and glaucoma. The axial length of right eye was 19.06mm and that of the left eye was 19.10mm. To achieve emmetropia, we implanted 27.0D IOL in the bag and 7.0D IOL in the sulcus of her left eye. We also implanted either two IOLs in the bag of her right eye, first one was 27.0D and second one was 10.0D. The findings obtained by using Ultrasound Bio Microscope (UBM) and slit lanp examination showed flattering by contact of the optics of the two IOLs implanted in the bag. The space between IOL and iris of the left eye was narrower than that of the right eye. The anterior chamber depth of the left eye was shallower than that of the right eye. Within two years the right eye's refraction shifted 1.0D hyperopic and the left eye's shifted 1.25D myopic. Therefore we should consider the possibility of myopic change after implanting one lens in the bag and the other lens in the sulcus.

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