MEDIX, God. 14 Br. 78  •  Stručni članak  •  Oftalmologija HR ENG

Verisyse intraokularna leća u korekciji afakijeVerisyse aphakic intraocular lens implantation

Zdravko Mandić, Ivanka Petric Vicković, Jelena Škunca Herman

Moderna operacija katarakte osim esktrakcije podrazumijeva i istovremenu ugradnju umjetne intraokularne leće. Idealna pozicija za ugradnju takve intraokularne leće je stražnja očna sobica, točnije pripremljena kapsularna vreća ili stražnja kapsula same leće. Dugi niz godina kod očiju s oštećenom stražnjom kapsulom intraokularna leća se implantirala u prednju očnu sobicu, ali zbog niza različitih postoperativnih komplikacija ovaj tip leće je gotovo napušten. Fiksacija intraokularne leće za skleru, šivanje haptika za sulkus cilijaris nakon početnog oduševljenja i dobrih rezultata kasnije je također pokazala niz nedostataka. Verisyse intraokularna leća također se fiksira na šarenicu, ali vrlo jednostavnom operacijskom tehnikom kojom se petlje poput kliješta uhvate za prednju ili stražnju površinu šarenice. Prema vlastitim iskustvima, kao i prema iskustvima ostalih autora publiciranih u literaturi, fiksacija ove leće u retro pupilarni prostor pokazala je niz prednosti i smanjila broj postoperativnih komplikacija u odnosu na ostale leće koje se koriste za korekciju afakije kod koje je došlo do značajnih oštećenja stražnje kapsule

Ključne riječi:
afakija; ugradnja leća, intraokularna; leće, intraokularne; oftalmološki kirurški postupci

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Modern cataract surgery involves cataract extraction and implantation of an artificial intraocular lens. The ideal position for the intraocular lens implant is the posterior chamber, where the lens is held in place within the capsular bag or the posterior capsule of the lens. In the aphakic eyes without proper capsule support due to posttraumatic or spontaneous dislocations of the crystalline lens or capsule loss during cataract extraction, the intraocular lens cannot be held firmly in place within the posterior chamber. In such cases, different intraocular lens implantation approaches and different types of intraocular lenses may be used. The anterior chamber intraocular lenses (ACIOLs) were used for a long time in the secondary intraocular lens implantation. However, this approach has been almost completely abandoned because of high complication rate (uveitis, glaucoma, hyphema, and bullous keratopathy) and replaced by techniques using sutures to secure posterior chamber intraocular lenses (PCIOLs), such as transsclerally sutured posterior chamber intraocular lenses. Nevertheless, the complications associated with these types of lenses remained high (intraocular bleeding, retinal detachment, intraocular lens dislocation, and intraocular lens tilt). Verisyse intraocular lens is fixated to the mid-peripheral portion of the iris in the anterior chamber or retropupillary. The intraocular lens haptics are attached to the iris by clips on both sides of the optic. The haptics have fine fissures to capture, through enclavation, a fold of iris stroma, where the iris is virtually immobile, less vascularized, and less reactive. According to our experience and experience of others surgeons, these characteristics and lower complication rates make the Verisyse intraocular lens an attractive alternative in the treatment of aphakic eyes.

Key words:
aphakia; lens implantation, intraocular; lenses, intraocular; ophthalmologic surgical procedures