亲水性丙烯酸酯人工晶状体植入后的生物相容性和并发症

摘要

BACKGROUND:Hydrophilic acrylic materials with good biocompatibility have been widely used in clinic. However, there are some problems about the biocompatibility and safety of hydrophilic acrylic intraocular lens after long-term clinical application. OBJECTIVE:To discuss the biocompatibility and stability issues and corresponding processing methods after hydrophilic acrylic intraocular lens implantation. METHODS:A computer-based search of Wanfang and PubMed database was performed for articles related to clinical application of hydrophilic acrylic intraocular lens published from 2005 to 2014. The keywords were “hydrophilic acrylic,intraocular lens” in Chinese and English, respectively. A total of 618 articles were initialy retrieved, and finaly 35 articles were included in result analysis. RESULTS AND CONCLUSION:As the hydrophilic acrylic intraocular lens is foldable, a smal incision is required for implantation and the operation is simple that cause less damage to the patients. In addition, the hydrophilic acrylic intraocular lens has poor bacterial and inflammatory cel adhesion, which leads to a low probability of infective endophthalmitis after implantation. But there is a high incidence of posterior capsule opacification as wel as some refractive errors and visual quality problems after implantation. Taken together, to solve these problems depends on the continuous improvements and updates of intraocular lens materials and designs.%背景：亲水性丙烯酸酯材料的生物相容性良好，在临床得到广泛的应用。但随着亲水性丙烯酸酯人工晶状体临床应用的时间延长，其长期的生物相容性及稳定性问题逐渐显现。目的：讨论亲水性丙烯酸酯人工晶状体植入后的生物相容性及稳定性问题和处理方法。方法：应用计算机检索万方数据库及PubMed数据库2005至2014年与亲水性丙烯酸酯人工晶状体临床应用相关的文献，中文检索词为“亲水性丙烯酸酯，人工晶状体/人工晶体”；英文检索词为“hydrophilic acrylic， intraocular lens”。检索得到618篇中英文文献，根据纳入排除标准选择35篇文献进行总结。结果与结论：亲水性丙烯酸酯人工晶状体具有良好的柔性可折叠性，折叠后能柔软而缓慢的展开，因此植入时所需切口小，手术操作简便时间段，患者损伤小。而且亲水性丙烯酸酯材料的细菌及炎性细胞的黏附性差，所以亲水性丙烯酸酯人工晶状体植入后的感染性眼内炎发生的概率低，但其植入后的后囊混浊发生率高，植入后也存在一定的屈光不正和视觉质量问题，这些问题的解决有赖于人工晶状体材料和设计的不断改进和更新。