Abstract：
Introduction: We previously reported a case of a patient with bilateral congenital cataract identified in the Ogasawara village, Bonin Islands, Japan, on a visit by an ophthalmologist and describe its course over 17 years from initial surgery. Here, we report on a secondary intraocular lens (IOL) implantation that was subsequently performed at 22 years and 5 months of age. Methods: After cataract surgery at 7 months, the aphakic patient began amblyopia treatment using extended-wear soft contact lenses (SCLs). After 10 years of age, SCLs were chosen to achieve crossed monovision considering the cosmetic appearance when facing other people. At 22 years of age, a secondary IOL implantation was performed. Secondary implant in the patient considered appearance and postoperative vision without glasses, we selected the crossed monovision method using a monofocal IOL. The postoperative targeted refraction for the right (non-dominant eye) and left eyes (dominant eye) planed - 0.33D and - 2.25D, respectively. Results: At 3 months after surgery, the corrected distance visual acuity (CDVA) with IOLs for the right and left eyes was 20/16 and 20/60, respectively, and the binocular visual acuity was 20/16 for distant vision and 20/25 for near vision. The CDVA for the right eye was: 20/13 × IOL = sph-0.25D and that for the left eye was: 20/13 × IOL = sph -1.75D D/cyl -0.50D/Ax170°. Although the exotropia was complicated by dissociated horizontal deviation and dissociated vertical deviation, there were no significant changes in ocular position before and after surgery. The patient was satisfied with achieving independence from spectacles and SCLs. Conclusion: The use of the crossed monovision method with monofocal IOLs in this patient and defective binocular function created a visual environment with no inconvenience in everyday life after secondary IOL implantation. In terms of secondary implant after amblyopia treatment, the IOL type or postoperative targeted refraction must be chosen to maintain or improve the visual environment obtained with the amblyopia treatment.
摘要：
简介：我们先前报道了一例在小gas原村发现的双侧先天性白内障患者，波宁群岛,Japan,在眼科医生的访问中，描述了从最初手术开始的17年的过程。这里,我们报道了随后在22岁零5个月时进行的二次人工晶状体(IOL)植入术.方法:白内障手术后7个月,无晶状体患者开始使用延长配戴软性隐形眼镜(SCLs)治疗弱视.10岁以后,考虑到面对其他人时的美容外观，选择SCL以实现交叉单视。在22岁的时候，进行了二次IOL植入.在没有眼镜的情况下，考虑患者的外观和术后视力，我们选择了使用单焦点IOL的交叉单视方法。术后右眼（非优势眼）和左眼（优势眼）的目标屈光计划-0.33D和-2.25D，分别。结果:术后3个月,右眼和左眼IOL矫正的远距视力(CDVA)分别为20/16和20/60,远距视力的双眼视力为20/16，近距视力为20/25。右眼的CDVA为：20/13×IOL=sph-0.25D，左眼的CDVA为：20/13×IOL=sph-1.75D/cyl-0.50D/Ax170°。尽管外斜视由于分离的水平偏差和分离的垂直偏差而变得复杂，手术前后眼位无明显变化。患者对实现独立于眼镜和SCL感到满意。结论：在该患者中使用交叉单视法单焦点IOL，双眼功能缺陷创造了视觉环境，二次IOL植入后的日常生活中没有不便。在弱视治疗后的二次植入方面，必须选择IOL类型或术后目标屈光,以维持或改善弱视治疗获得的视觉环境.
