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[摘要]
目的:探讨白内障超声乳化联合人工晶状体(IOL)囊袋内悬吊固定治疗晶状体半脱位(SL)的疗效。
方法:回顾性分析2014-06/2017-12于我院就诊的SL(悬韧带断离范围≤270°)患者18例18眼,均行白内障超声乳化联合IOL单襻或双襻囊袋内悬吊固定术,其中2眼同时行25G微创玻璃体切除术。术后随访6~12mo,观察最佳矫正视力(BCVA)、眼压(IOP)、IOL位置、眼底情况等,记录术中和术后并发症情况。
结果:本组患者均顺利完成手术。术后3mo,BCVA(0.43±0.30)较术前(1.48±0.68)明显改善(t=7.30,P<0.01),IOP均恢复正常(≤21mmHg),IOL均处于正位,无偏心、移位。本组患者术中和术后均未出现严重眼部并发症。
结论:单襻或双襻囊袋内悬吊固定IOL是治疗SL的一种有效的手术方式,不仅可以保持IOL位于正常生理位置、恢复患者视功能,而且经济实用,避免囊袋张力环(CTR)相关的并发症发生。
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[Abstract]
AIM: To investigate the clinical effect of transscleral sutured fixation intraocular lens(IOL)implanted in the capsular bag combined with phacoemulsification for subluxated lens(SL).
METHODS: A prospective study of 18 consecutive cases(18 eyes)with SL(≤270°)was treated with phacoemulsification by Nagahara's chop method combined with the iris hook. Then according to the extent of SL, one or two IOL haptics were transscleral sutured suspension in the capsular bag. Moreover, two cases were performed 25G minimal invasive vitrectomy. The clinical efficacy was observed such as visual acuity, best corrected visual acuity(BCVA), intraocular pressure(IOP), the position of IOL and complications.
RESULTS: All cases were performed successfully. With following-up ranged from 6-12mo, the BCVA was improved obviously, which had significant difference contrasted to that of preoperation(t=7.30, P<0.01). All cases' IOP ≤21mmHg, the position of IOL were normal without dislocation. No several complications took pace in intraoperative or postoperative surgical process.
CONCLUSION: Without implanting capsular tension ring(CTR), IOL in the capsular bag sutured fixation by one or two haptics suspension is an alterative approach for SL. This method maintains the position of IOL and rehabilitates visual acuity, and obviates CTR dislocation. So this way is effective and economical to be accepted by some basic hospital.
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