玻璃体切割术后人工晶体植入术  

Intraocular lens implantatiom after pars plana vitrectomy

作　　者：刘国军[1] 仇宜解[1] 于湛[1] 方静[1] 王海存[2] 康维强[2] 李树宁[3] 

机构地区：[1]青岛市海慈医疗集团青岛大学医学院附属海慈医院眼科中心,青岛266033 [2]青岛市海慈医疗集团青岛大学医学院附属海慈医院彩超室,青岛266033 [3]青岛大学医学院附属医院眼科

出　　处：《中国实用眼科杂志》2005年第3期230-233,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的　探讨玻璃体切割术后人工晶体 (intraocularlens,IOL)植入术的效果及硅油填充眼IOL度数的测算方法。方法　 1 硅油填充眼IOL度数测算。 2 建立玻璃体腔液体灌注系统维持术中和术后眼压分别为 2 7 2cmH2 .O (相当于 2 0mmHg)和 4. 0 8cmH2 O ( 30mmHg)。 3 硅油填充眼先行眼内硅油取出术 ,然后行后房型IOL植入术。 4 植入后房型IOL :若后囊完整 ,植入囊袋内IOL ;前囊完整植入睫状沟固定IOL ;前后囊缺损植入睫状沟缝合固定IOL ;虹膜缺损或瞳孔极度散大 ,植入带虹膜IOL。 5 术后随访 2 . 5～ 39个月 ,平均 1 4 5个月。结果　 38例 ( 38只眼 )成功地进行了后房型IOL植入术 ,其中囊袋内植入IOL 6例 ,睫状沟固定IOL 1 9例 ,睫状沟缝合固定IOL 9例 ,植入带虹膜IOL- 4例。硅油取出联合IOL植入术 1 0例。术后视力≥ 0 .1 32例 ( 84 . 2 % ) ,≥ 0 32 2例( 57 .9% )。硅油填充眼术后屈光度 ( - 1 . 58± 0 . 6 1 )D ,与术前预见的屈光度相比 ,差别无统计学意义 (P >0 0 5)。术中并发症有视网膜损伤 ( 2例 )及睫状体出血 ( 2例 ) ,术后并发症有玻璃体出血( 3例 )、视网膜脱离 ( 2例 )及眼球萎缩 ( 1例 )。结论　玻璃体切割术后IOL植入术的效果满意 ,术中术后眼压维持对于减少术中术后并发症至关重要 ,Objective To study the results of intraocular lens(IOL)implantation after pars plana vitrectomy and the method of measuring the power of IOL in silicone oil-filled eye.Methods Vitreous irrigation was established to maintain intraocular pressure(IOP)at the level of 27 2 cmH 2O(equal to 20mmHg)in the operation and 40 8 cmH 2O(30mmHg)after the operation,respectively.Silicone oil was removed in Silicone oil-filled eye and posterior chamber(PC)IOL implantation was then performed.The mean follow-up period after the operation was 14 5 months(range,2 5～39 months).Results 38 cases(38 eyes)underwent PC IOL implantation successfully,of them,6 cases in the bag,19 cases on the peripheral anterior capsule,9 cases with sutured PC IOL in the sulcus and 4 cases with IOL with the iris in the sulcus.10 cases underwent combined silicone oil removal and PC IOL implantation.32 cases(84 2%)had obtained post-operative visual acuity ≥0 1,22 cases(57 9%)≥0 3.The mean post-operative refraction in silicone oil-filled eye was -1 58±0 61 diopters.The difference between post-operative and the predicted refraction was not significant( P >0 05).The complications included retinal injury(2 cases),hemorrhage of the ciliary body(2 cases)in the operation and vitreous hemorrhage(3 cases),retinal detachment(2 cases)and eyeball atrophy(1 cases)after the operation.Conclusions IOL implantation after pars plana vitrectomy are satisfactory.To decrease intra-and post-operative complications,it is very important to maintain IOP during and after the operation.The method of measuring the power of IOL in silicone oil-filled eye can be widely used.

关 键 词：IOL植入术 植入 硅油填充眼 术后 玻璃体切割术 后房型 固定 度数 结论 推广 

分 类 号：R779[医药卫生—眼科] R776.1[医药卫生—临床医学]