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A stepwise approach for the management of capsular contraction syndrome in hinge-based accommodative intraocular lenses

机译：基于铰链的调节性人工晶状体囊膜收缩综合征管理的逐步方法

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Purpose: The aims of this study are to define the various stages of capsular contraction syndrome (CCS) and its effect on refractive error with hinge-based accommodating intraocular lenses (IOLs) and to describe a systematic approach for the management of the different stages of CCS. Methods: Hinge-based accommodative IOLs function via flexible hinges that vault the optic forward during accommodation. However, it is the flexibility of the IOL that makes it prone to deformation in the event of CCS. The signs of CCS are identified and described as posterior capsular striae, fibrotic bands across the anterior or posterior capsule, and capsule opacification. Various degrees of CCS may affect hinge-based accommodating IOLs in a spectrum from subtle changes in IOL appearance to significant increases in refractive error and loss of uncorrected visual acuity. The signs of CCS and its effect on IOL position and the resulting changes in refractive error are matched to appropriate treatment plans. Results: A surgeon can avoid CCS and manage the condition if familiar with the early signs of CCS. If CCS is identified, yttrium–aluminum–garnet laser capsulotomy should be considered. If moderate CCS occurs, it may be effectively treated with insertion of a capsular tension ring. If CCS is allowed to progress to advanced stages, an IOL exchange may be necessary. Conclusion: Surgeons should be familiar with the stages of CCS and subsequent interventions. The steps outlined in this article help to guide surgeons in the prevention and management of CCS with hinge-based accommodative IOLs in order to provide improved refractive outcomes for patients.
机译：目的：本研究的目的是确定囊性收缩综合征（CCS）的各个阶段及其对基于铰链的适应性人工晶状体（IOL）对屈光不正的影响，并描述一种系统的方法来管理不同阶段的CCS。方法：基于铰链的调节性IOL通过灵活的铰链起作用，该铰链在调节过程中使光学器件向前弯曲。但是，正是IOL的灵活性使其在CCS情况下易于变形。 CCS的体征被识别并描述为后囊纹，前囊膜或后囊膜的纤维化带以及囊膜混浊。从IOL外观的细微变化到屈光不正的明显增加以及未矫正的视敏度的丧失，不同程度的CCS可能会影响光谱中基于铰链的可容纳IOL。 CCS的体征及其对IOL位置的影响以及所导致的屈光不正的变化与适当的治疗计划相匹配。结果：如果熟悉CCS的早期征兆，外科医生可以避免CCS并控制病情。如果识别出CCS，则应考虑钇铝石榴石激光囊切开术。如果发生中度CCS，可通过插入囊张力环有效治疗。如果允许CCS进入高级阶段，则可能需要进行IOL交换。结论：外科医生应熟悉CCS的阶段和随后的干预措施。本文概述的步骤有助于指导外科医生使用基于铰链的调节性IOL预防和治疗CCS，从而为患者提供更好的屈光效果。

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