目的：探讨经反向巩膜瓣IOL睫状沟缝合固定术的临床应用。

方法：回顾性分析就诊于我院眼科需行Ⅱ期IOL植入的14例14眼无晶状体眼患者临床资料。采用经反向巩膜瓣睫状沟缝合固定术行IOL植入。术中制作以穹窿部为基底的插袋式巩膜瓣。观察患者手术前后的视力、术后眼压、眼前节反应和IOL稳定性。

结果：术后随访时间3.5～6mo。术前最佳矫正视力(LogMAR视力表)为0.50±0.54，术后1mo裸眼视力0.46±0.39，两者无差异(P>0.05)。术后1mo最佳矫正视力0.36±0.35，较术前最佳矫正视力有所提高。1例1眼患者术后IOL倾斜，经调整后IOL位正。3例3眼患者在术后早期眼压升高，给予降眼压药物对症处理后眼压正常，术后1mo随访眼压在正常范围内(16.4±2.6mmHg)。1例1眼患者术后玻璃体腔出血，1例1眼患者术后眼内炎症反应重，治疗后均恢复。术后无黄斑囊样水肿、脉络膜脱离、视网膜脱离等严重并发症。

结论：经反向巩膜瓣IOL睫状沟缝合固定术是一种简便、安全、有效的术式。

METHODS: The clinical data of 14 patients(14 eyes )who needed secondary IOL implantations due to different reasons in our department were retrospectively analyzed. All cases underwent ciliary sulcus suture fixation of IOL through reverse partial-thickness scleral flap. One or two reverse partial-thickness scleral flap were made during the surgery. Preoperative and postoperative visual acuity, intraoperative and postoperative complications and the stability of the IOLs were observed.

RESULTS: The mean follow-up time was 3.5-6mo. The preoperative best-corrected visual acuity(BCVA)(LogMAR)was 0.50±0.54, and the uncorrected visual acuity(UCVA)at 1mo after surgery was 0.46±0.39(P>0.05). The BCVA at 1mo after surgery was 0.36±0.35, which was improved compared with the preoperative one, but the difference was not statistically significant(P>0.05). Three cases had transient intraocular hypertension postoperatively. One case had vetrious hemorrhage. One case had moderate anterior chamber inflammatory response. There were serious complications, such as cystoid macular edema, choroidal detachment, retinal detachment during the follow-up period.

CONCLUSION: Ciliary sulcus suture fixation of IOL through reverse partial-thickness scleral flap is a effective and safe method for aphakia.