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[摘要]
目的:探讨2.4mm小切口改良Akreos Adapt AO折叠人工晶状体经巩膜睫状沟固定术的的疗效。
方法:选择由外伤、先天、手术等原因造成晶状体后囊破损或悬韧带离断不能正常植入后房型人工晶状体的患者37例37眼,制作角膜缘垂直的“钱包样”板层巩膜瓣,采用博士伦Akreos Adapt AO折叠人工晶状体,利用瑞士产VE2200人工晶状体植入系统,经过透明角膜缘内2.4mm小切口,由双针各带有环形10/0的聚丙烯缝线将人工晶状体固定于睫状沟,埋藏式结扎缝线于板层巩膜瓣内。
结果:所有患者术后植入的人工晶状体居中,裸眼视力均有不同程度的提高。术后3mo视力≥0.8者3眼(8%); >0.4~≤0.6者18眼(49%); ≤0.4者16眼(43%)。术前、术后3mo平均角膜散光分别为1.73±1.22、1.62±1.34D,差异无统计学意义(P>0.05)。术中、术后除1例出现玻璃体积血,2例角膜水肿外,未见其它严重并发症。所有患者均无固定线结暴露。
结论:2.4mm微创小切口行Akreos Adapt AO折叠人工晶状体睫状沟固定术,手术切口小、晶状体悬吊稳固、居中性好、视力恢复满意、术后角膜散光变化小。固定线结扎方法具有线结埋藏无暴露并同时关闭巩膜瓣切口的特点,操作步骤简捷、手术并发症少、实用有效可行。
[Key word]
[Abstract]
AIM:to observe the effect of modified surgery of small incision transscleral sulcus fixation of Akreos Adapt AO foldable intraocular lens.
METHODS:The study included 37 patients(37 eyes)who could not be performed the regular implantation of posterior chamber intraocular lens for the rupture of posterior capsule or for the zonular dialysis caused by trauma, congenital or surgery. Bausch & lomb Akreos Adapt AO fordable intraocular lens, VE22000 implantation device were applied in this study. Regular 2.4mm transparent cornea incision and pocket-like sclera incision were made. The intraocular lens were transscleral sulcus fixed by 10/0 prolene suture and the suture was buried within the scleral incision.
RESULTS:The intraocular lenses were all well posited and the postoperative visual acuity(VA)was improved in all patients. Three eyes(8%)were≥0.8 while 18 eyes(49%)>0.4~≤0.6 and the remaining 16(43%)were ≤ 0.4 at 3mo after surgery.Cornea astigmatism was 1.73D±1.22D and 1.62±1.34D before and after surgery, no statistic significance was observed(P<0.05). No severe complication occurred during or after surgeries except for 1 vitreous hemorrhage and 2 cornea edema. There was no suture exposure found.
CONCLUSION:The modified surgery of 2.4mm small incision transscleral sulcus fixation of Akreos Adapt AO foldable intraocular lens has the following advantages such as:good visual results, less postoperative astigmatism, small surgery incision, steady intraocular lens, less manipulation, less complication and more effective.
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