摘要
目的观察比较不同术式人工晶状体植入术治疗玻璃体切除术后无晶状体眼的临床疗效。方法回顾2007年1月至2011年12月我院收治的玻璃体切除术后144例(146只眼)无晶状体眼患者的病例资料,分析比较不同术式植入人工晶状体后的临床疗效及并发症发生情况。结果据病情行不同术式的人工晶状体植入,其中对有残留周边晶状体囊膜者行人工晶状体睫状沟内植入42只眼;对无囊膜残留者行经巩膜缝线固定人工晶状体植入术41只眼;前房型人工晶状体植入63只眼,术后均随访3个月以上:①138只眼裸眼视力提高2行以上占94.5%,术后裸眼视力达到或超过术前最佳矫正视力共有103只眼(70.5%),其中睫状沟植入组31只眼(73.8%),前房型人工晶状体植入组52只眼(82.5%),巩膜缝线固定组26只眼(63.4%);②常见并发症:术中出血9只眼(前房型人工晶状体组2只眼占3.2%,巩膜缝线固定组7只眼占17.1%,);术后出血11只眼(前房型人工晶状体组2只眼占3.2%,巩膜缝线固定组9只眼占22.0%,);术后早期并发症:眼压≤8 mm Hg共25只眼(睫状沟植入组3只眼占7.1%,前房型人工晶状体组10只眼占15.9%,巩膜缝线固定组12只眼占29.3%,);眼压≤5mm Hg共7只眼(前房型人工晶状体组4只眼占6.3%,巩膜缝线固定组3只眼占7.3%,);术后发生浅前房4只眼均为前房型人工晶状体植入组(占6.3%);角膜水肿5只眼均为前房型人工晶状体植入(7.9%);前房炎症反应4只眼均为前房型人工晶状体植入(6.3%)。远期并发症:黄斑囊样水肿6只眼(前房型人工晶状体组3只眼4.8%,巩膜缝线固定组3只眼占7.3%)。结论玻璃体切除术后无晶状体眼采用不同方式人工晶状体植入术后效果肯定,其中睫状沟植入人工晶状体术后并发症少,前房型人工晶状体和人工晶状体睫状沟植入术后视力矫正优于巩膜缝线固定人工晶状体植入,但对无囊膜支撑和不适于前房型人工晶状体植入的无晶状体眼,经巩膜缝线固定术也是有效的术式。
Objective To oomlmre the clinical outcomes of multiple intraocular lens implantation techniques as a seeondary elective surgery-for aphakia eyes that underwent vitrectomy. Methods Reconls of 146 eyes that received in- traomdar lens （IOL） implantion between January 2007 and December 2011 weer reviewed. Clin/eal outcomes, including complications wexe retrospectively evaluated. Results Aeeopling to ocular conditions, different techniques were used to implant IOL. Forty-two eyes with capsule or mmde support were treated with ciliary groove lenses （CG-IOL） ; 41 eyes w/th no capsule support were treated w/th tramscleral fixed lenses （ TSF-IOL） ; other 63 eym were treated with anterior chamhe.r lemee （AC-IOL）. All patients were followed at least 3 mouths. （ I ） Postoperative visual acuity was/mproved two or more lines in 138 eyes （94.5%）. In additien, postoperative visual acuity was equal or better than best-corrected preoperative visual acuity in 103 eyes. Ameq them, 31 eyes were implanted with CG-IOL; 52 eyes received AC-IOL, and 26 eyes wexe treated with TSF-IOL. （2） Common complications included hemorrhage during the surgery in 2 eyes implanted with AC- IOL and 7 eyes implanted with TSF-IOL, postoperative hemorrhage in 2 eyes implanted with AC-IOL and 9 eyes implanted with TSF-IOL, ocular hypotension （IOP≤8 mm Hg in 3 eyes implanted with CG-IOL, 10 eyes implanted with AC-IOL, and 12 eyes implanted with TSF-IOL; IOP≤5 mm Hg in 4 eyes implanted with AC-IOL and 3 eyes implanted with TSF- IOL）, shallow anterior ch,,mher in 4 eyes implanted with AC-IOL）, corneal edema in 5 eyes implanted with AC-IOL, posi- tive Tyndall sign in 4 eyes implanted with AC-IOL,cystdd macular edema in 3 eyes implanted with AC-IOL and 3 eyes iraplanted with TSF-IOL. Conclusion Intraocular lens implantation is the best option to treat aphakia, eyes underwent vitrectomy. Implantation locations include eiliazy groove, trans-seleral fixed and alttexior chamber. All of them can correct refractire error effectively, lmplantatioa in the ciliary groove has much lees complication. AC-IOL and CG-IOL implantation are better than TSF-IOL implantation with regards to postoperative visual acuity, but the latter technique is particularly useful for eyes with no capsule or zonule support.
出处
《临床眼科杂志》
2013年第3期193-197,共5页
Journal of Clinical Ophthalmology
