目的：探讨以眼前节结构紊乱重建，联合以增殖膜为依托行Ⅱ期后房型人工晶状体(IOL)植入的手术方法，并评价其疗效。

方法：对我院1995-09/2015-10眼球穿通伤致眼前节不同程度结构紊乱并行眼前节结构重建联合Ⅱ期后房型人工晶状体植入术患者(156眼)的资料进行回顾性分析。所行手术包括部分穿透性角膜移植、前粘连松解术、虹膜根部离断缝合术、后粘连松解术、瞳孔成形术、瞳孔区增殖膜造孔术和以增殖膜为依托行Ⅱ期后房型人工晶状体植入术。对术中及术后并发症、视力、眼压、角膜内皮细胞、人工晶状体位置等情况进行观察。随访3～18mo。

结果：患者156眼均手术顺利，术后矫正视力≥0.5者123眼(78.8%)，其中≥0.8者17眼(10.9%)，≤0.4者33眼(21.2%)。术后人工晶状体位置：正位133眼(85.3%)，稍偏离中心者23眼(14.7%)； 术后8眼前房出血，其中6眼经保守治疗痊愈，2眼经原切口吸出前房血膜。5眼角膜斑翳致密，位于角膜中央者行部分穿透性角膜移植，2mo后产生排异反应，经保守治疗痊愈。全部患者术后炎症反应轻微，无严重远期并发症。

结论：在重建眼前节结构联合Ⅱ期人工晶状体植入时，在预植入人工晶状体的位置，存在足够的增殖膜可支撑人工晶状体，而无需采用缝线固定的方法，这样可避免因缝线所致的各种并发症发生。

METHODS: Totally 156 eyes with penetrating injury had varying degrees of anterior segment disorders which had secondary intraocular lens implantation based on proliferative membrane to anterior segment reconstruction. Including partial penetrating keratoplasty, front-adhesion release, iris root suture, post-adhesion release, pupillary plasty, hole making in pupil area proliferative membrane and secondary intraocular lens implantation based on proliferative membrane. All patients were followed up 3-18mo.

RESULTS: The surgeries were successful in all patients. The corrected visual acuity of 123 eyes(78.8%)were ≥0.5, 17 eyes(10.9%)were ≥0.8 and 33 eyes(21.2%)were ≤0.4. Postoperative intraocular lens position was 133 eyes(85.3%), intraocular lens slightly off the center of 23 eyes(14.7%). Anterior chamber hemorrhage occurred in 8 eyes, 6 of them were recovered by conservative treatment and the blood membrane in another 2 eyes were sucked out through primary incision, and 5 cases of corneal plaque dense in the center of the cornea are partially penetrating keratoplasty. After 2mo, a rejection reaction occurs, which is cured by conservative treatment. All patients had slight postoperative inflammation and without severe long-term complications.

CONCLUSION: Reconstruction of the anterior segment of the eye, proliferative membrane can support the intraocular lens at the pre-implantation of the intraocular lens, without the need for suture fixation, thus avoiding various complications due to sutures.