Abstract: for patients with short ocular axis, especially small eyeball, whether small and thin ORL can become one of the options due to the crowded anterior segment of the eyeball, and whether it is possible to reduce pupil block and reduce the possibility of secondary glaucoma after implantation need to be confirmed by more objective research. The continuous improvement and development of
intraocular lens (IOL) provides convenience for cataract patients. How to select the ORL most suitable for a specific patient from a large number of orls does need a lot of clinical verification and careful observation.
many scholars have done a lot of research on the performance, shape and clinical use of various orls. Here, we only introduce the experience and experience of selecting several common orls in clinical work, in order to discuss with ophthalmologists how to select IOL to maximize the benefits of patients with white cataract.
select the appropriate material IOL
for most elderly cataract patients without systemic and ocular complications. There is no special restriction on the material selection of IOL. Polymethylmethacrylate (PMMA), silica gel, hydrophilic and hydrophobic acrylic acid are available.
complicated with cataract, especially patients with chronic uveitis, fundus diseases or glaucoma, we mostly choose IOL or hydrophobic acrylic vinegar IOL whose surface is treated with heparin, because its surface is treated with heparin can reduce the postoperative inflammation and immune response, and reduce the incidence of postoperative endophthalmitis and posterior cataract.
hydrophobic acrylic vinegar has high biocompatibility and low incidence of posterior cataract, so it is also suitable for children with cataract. The
silica gel OIL has been widely used in clinical practice because of its stable structure, flexible material and long-term retention in the eye. It has the longest history in folding orL.
choosing intraocular lens
IOL dislocation and offset is an important reason for the decline of visual quality after cataract surgery, and it is also the main reason for removing ORL at present. In order to prevent IOL offset, we should not only keep the integrity of capsule during operation, but also pay attention to the selection of its shape and support characteristics. The shape and size of ORL should be paid attention to in the selection of
high myopia complicated with cataract due to the characteristics of long eye axis, large lens capsule and loose lens suspensory ligament.
encounter patients with large bags. It is recommended to use bags to support IOL well to prevent its deviation. Especially for the aspheric IOL which is widely used in clinic, its eccentricity and inclination will increase the aberration and reduce the imaging quality.
in case of posterior capsule rupture, we must take into account that the oil may be misaligned in the future. It is recommended to replace other types of IOL in time. At present, there is a lack of relevant research on which IOL of
is more suitable for large pouch and which one is suitable for small eyeball. We can only choose according to experience.
for patients with short ocular axis, especially small eyeballs, whether small and thin ORL can become one of the options due to the crowded anterior segment of the eyeball, and whether it is possible to reduce pupil block and reduce the possibility of secondary glaucoma after implantation need to be confirmed by more objective research.
choose the appropriate degree of intraocular lens. The choice of IOL degree of
determines the refractive state after operation. Since most orls have no adjustment ability, we usually reserve a diopter of about. 05D for patients with emmetropia or close to emmetropia before operation. However, it is important to select the degree of ORL in combination with the actual situation of the patient.
patients who often engage in close work should reserve about 1.05-1.0d, or even more; Patients with more
outdoor activities, especially those who often drive, should be reserved as much as possible.
for patients with high myopia, we should consider the possible axial length measurement error caused by posterior scleral staphyloma before operation, so that there is a large error in IOL degree.
the aspheric IOLs (IOLs) of intraocular lens
with appropriate aberrations were selected in order to correct the corneal spherical aberration, reduce the total eye aberration and improve the visual quality, which were gradually applied in clinic.
avoid the blind use of intraocular lens
some articles put forward that there are many kinds of IOL. It is best to use different kinds of orols from different companies for personalized requirements. However, we believe that at present, all kinds of IOL have more comprehensive types, and different kinds of IOL have different a constant values, In order to avoid calculation errors when selecting different orls, it is easy to make errors when performing surgery on a large number of patients. It is best to choose several familiar varieties.
in short, with the development and use of more and more kinds of ORL, the scientific selection of ORL should start from the actual condition of patients and fully consider the characteristics of cataract and the needs of patients.
doctors should fully understand and understand the characteristics of different orls, so that patients after cataract surgery can not only achieve the target vision, but also achieve the perfection of refraction.