目的：评估25G玻璃体切割(PPV)联合人工晶状体(IOL)睫状沟缝合固定置换术治疗IOL囊袋复合体脱位于玻璃体腔的临床效果。

方法：回顾性分析我院2015-01/2020-01应用25G玻璃体切割联合IOL睫状沟缝合固定置换术治疗IOL囊袋复合体完全脱位于玻璃体腔的患者21例21眼的临床资料。

结果：所有患者术中均顺利取出脱位的IOL复合体，未出现医源性视网膜损伤，术中发现视网膜裂孔4眼，视网膜格子样变性2眼，分别予以视网膜激光光凝。随访6～18mo，BCVA(LogMAR)由术前的0.40±0.30提高到术后的0.33±0.25(P=0.040)。所有病例末次随访BCVA均达到术前BCVA。术后等效球镜度与术前IOL屈光度预测值相差的绝对值≤0.75D。末次随访时所有患者IOL位置良好，未发生视网膜脱离等并发症。

结论：25G玻璃体切割联合IOL睫状沟缝合固定置换手术是治疗IOL囊袋复合体脱位安全有效的方法。

METHODS: A retrospective analysis of 21 patients(21 eyes)in our hospital who applied 25G PPV combined with IOL ciliary sulcus suture and fixation replacement in our hospital from January 2015 to January 2020 to treat the IOL capsular complex completely detached from the clinical data.

RESULTS: All the cases were successfully removed the dislocated IOL complex during the operation. There was no iatrogenic retinal damage. During the operation, 4 cases(4 eyes)were found to have the retina hole, 2 cases(2 eyes)were found to be retinal lattice degeneration area, which were treated with laser photocoagulation of the retina. Follow-up for 6-18mo, best corrected visual acuity(BCVA)(LogMAR)increased from 0.40±0.30 before operation to 0.33±0.25 after operation(P=0.040). The BCVA at the last follow-up of all cases reached the BCVA before surgery. The absolute value of the difference between the postoperative spherical equivalent power and the preoperative IOL refractive power prediction value is less than or equal to 0.75D. At the last follow-up, the position of the intraocular lenses in all cases was good, and there were no complications such as retinal detachment.

CONCLUSION: The technique of 25G PPV and the exchange of IOL ciliary sulcus fixation with intraocular IOL capsule complex is a safe and effective procedure for dislocation of IOL-capsular bag complex entirely into the vitreous cavity.