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[摘要]
目的:评价无线结巩膜固定缝线后房型人工晶状体(intraocular lens,IOL)手术的安全性和稳定性。
方法:回顾性分析2009-01/2014-10在沈阳何氏眼科医院因晶状体脱位、白内障术中后囊膜破裂、玻璃体切割术后无晶状体眼的患者35例39眼的临床资料,手术采用无结扎线结巩膜层间埋线方法固定后房型IOL,术中不制作巩膜瓣。观察和分析术前及术后最佳矫正视力(best-corrected visual acuity,BCVA)、眼压、术后IOL稳定性和相关并发症等。
结果:术后3mo,0.1≤BCVA<0.3者9眼(23.1%),0.3≤BCVA<0.5者20眼(51.3%),0.5≤BCVA<0.8者6眼(15.4%),0.8≤BCVA<1.0者4眼(10.3%); 术中2眼出现虹膜根部出血,术后2wk内完全吸收; 术后3眼出现一过性眼压升高,3眼出现角膜水肿,对症用药后均在1wk内恢复正常。术后无1眼出现角膜内皮失代偿、睫状体脱离、视网膜脱离及眼内炎等并发症。术后平均随访时间24(3~60)mo,未见IOL倾斜/脱位、缝线暴露、巩膜固定缝线处变薄和/或溶解等并发症的发生。
结论:无线结巩膜缝线固定后房型IOL是无晶状体伴无充分囊膜支撑眼植入后房型IOL安全有效的治疗方法,减少了术后缝线相关并发症的发生。
[Key word]
[Abstract]
AIM:To evaluate the safety and stability of knotless scleral-fixated posterior chamber intraocular lens(PCIOL).
METHODS:Thirty-nine eyes of 35 patients with dislocation of lens, capsule broken after cataract extraction or aphakic eyes after vitrectomy were retrospectively analyzed. They were undergone knotless scleral-fixated PCIOL without scleral flap from January 2009 to October 2014 at He Eye Hospital in Shenyang. Pre-operative and postoperative best-corrected visual acuity(BCVA), intraocular pressure(IOP), the stability of intraocular lens and complications were observed and analyzed.
RESULTS:The BCVA of 9 eyes(23.1%)were 0.1≤BCVA<0.3, 20(51.3%)eyes were 0.3≤BCVA<0.5, 6 eyes(15.4%)were 0.5≤BCVA<0.8, and 4 eyes(10.3%)were 0.8≤BCVA<1.0 at 3mo postoperatively. Two eyes had mild iridemia intraoperatively, which were absorbed in 2wk. Three eyes had transient ocular hypertension, and three eyes had cornea edema postoperatively, all of them were cured through drug treatment in a week. There had no corneal decompensation, ciliary detachment, retinal detachment and endophthalmitis on any patient. The mean follow-up time was 24(3~60)mo. There was no complications of IOL tilting/dislocation, suture exposure, scleral attenuation or scleral dissolution postoperatively.
CONCLUSION:The knotless scleral-fixated PCIOL is a safe and effective technique for aphakic eyes with deficient posterior capsular support, which reduces postoperative suture related complications.
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