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[摘要]
目的:评价人工晶状体(intraocular lens,IOL)单襻囊袋内缝合固定治疗外伤性晶状体半脱位手术的方法、效果及可行性。
方法:选择2013-03/2015-03我院术前晶状体脱位范围不大于2个象限的外伤性白内障患者12例12眼,行拦截劈裂超声乳化白内障吸除术或小切口晶状体摘除术。IOL采用单襻囊袋内缝合固定术,即一侧襻植入未见明显脱位方位囊袋内,将聚丙烯缝线捆绑另一侧襻的中部后穿过囊膜赤道部固定巩膜壁的方法植入脱位最严重方位的囊袋内。术后观察裸眼视力、最佳矫正视力(best corrected visual acuity,BCVA)、眼压、角膜内皮细胞计数、IOL位置等指标,并对手术并发症进行记录。
结果:手术完成均顺利,术后视力提高明显,术后随访6~12mo,随访期间BCVA≥0.8者2眼,0.4~0.6者7眼,≤0.3者3眼,67%的视力稳定在0.5~0.6; 术后随访期间眼压正常,手术对角膜内皮细胞影响轻微,所有IOL均处于正位,术中、术后未有严重并发症发生。
结论:在不植入囊袋张力环(capsular tension ring,CTR)的情况下,使用IOL单襻囊袋内缝合固定治疗外伤性晶状体半脱位,可显著提高患者的BCVA,并且安全性好,有效地避免了IOL的夹持和偏位,临床疗效满意。
[Key word]
[Abstract]
AIM: To evaluate the safety and efficacy of one transscleral sutured fixation intraocular lens implanted in the capsular treating traumatic lens dislocation.
METHODS: Twelve eyes with lens subluxation from 12 patients during Mar. 2013 to Mar. 2015 were reviewed. The stopping and chopping method combined with manual nuclear extraction was performed in extent of lens subluxation less than 1/2 quadrant and transscleral sutured fixation intraocular lens implanted in the capsular. Visual acuity, best-corrected visual acuity, intraocular pressure, corneal endothelial cell count and the position of IOL were observed and recorded.
RESULTS: All the surgeries were performed successfully. Patients were followed up for 6-12mo. During the follow-up period, the number of eyes for BCVA ≥0.8, 0.4-0.6 and ≤0.3 was 2, 7 and 3, respectively. It meant 66.67% of the eyes showed BCVA in 0.5-0.6. Intraocular pressure and the position of all intraocular lens were normal. Effects of operation on corneal endothelial cells were slight. No complications took place in and after surgery.
CONCLUSION: Without implanting capsular tension ring(CTR), we successfully use the intraocular lens(IOL)single loop suture fixation in the capsular bag for the treatment of the patient with traumatic lens dislocation. It indicates that the pressure and place shift from the use of IOL avoided by this method without implantation of CTR. This method is safe and effective for the treatment of eyes with traumatic lens dislocation.
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