Transient vacuolar changes of the crystalline lens in patients using a dispersive ophthalmic viscosurgical device  

作　　者：Yue Zhou Wan Chen Yu Zhang Zhuo-Ling Lin Jing Li Hui Chen Wei-Rong Chen 

机构地区：[1]State Key Laboratory of Ophthalmology,Zhongshan Ophthalmic Center,Sun Yat-sen University,Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science,Guangzhou 510060,Guangdong Province,China

出　　处：《International Journal of Ophthalmology(English edition)》2023年第11期1794-1799,共6页国际眼科杂志（英文版）

基　　金：Supported by the National Key R&D Program of China(No.2020YFC2008200);the National Natural Science Foundation of China(No.81970778,No.82271066,No.81970813);the Natural Science Foundation of Guangdong Province(No.2023A1515011198);Guangzhou Municipal Science and Technology Project(No.SL2022A03J00553).

摘　　要：AIM:To report the clinical prognosis and pathological findings of accidental lens vacuolar changes in eyes with intraoperative exposure to a dispersive ophthalmic viscosurgical device(OVD).METHODS:Two patients who developed transient lens vacuolar changes during uneventful persistent pupillary membrane(PPM)removal surgery were presented and followed up.This event was speculated to be associated with an intraoperative dispersive OVD DisCoVisc(hyaluronic acid 1.6%-chondroitin sulfate 4.0%)exposure.Then,to provide the pathological basis for our speculation,another four cataract patients were randomly exposed to different OVDs,and their anterior lens capsules were investigated with transmission electron microscopy(TEM).RESULTS:After months,the subcapsular vacuoles in both PPM cases were gradually disappeared without visual deterioration.For the cataract patients,similar lens changes were observed intraoperatively in those exposed to a dispersive DisCoVisc but not a cohesive OVD IVIZ(sodium hyaluronate gel 1.0%).In addition,marked ultrastructural changes,including chromatin condensation,extensive cytoplasmic vacuoles,and obvious intercellular space between lens epithelial cells in the anterior lens capsules of all eyes exposed to DisCoVisc,were observed by TEM.CONCLUSION:The lens vacuolar changes may be associated with a dispersive OVD exposure.Therefore,it is not preferable to use dispersive OVDs in patients with transparent lenses or without the intention of lens extraction.In addition,close follow-ups instead of immediate lens extraction are recommended for the occurrence of similar lens lesions.

关 键 词：vacuolar change crystalline lens ophthalmic viscosurgical devices lens epithelial cells transmission electron microscopy 

分 类 号：R777.34[医药卫生—眼科]