囊袋张力环植入治疗晶状体悬韧带异常的2年临床效果  

Clinical efficacy of management of zonular abnormalities with capsular tension ring： a two-year follow-up study

作　　者：杨晋[1] 卢奕[1] 罗怡[1] 汪琳[1] 

机构地区：[1]复旦大学附属眼耳鼻喉科医院眼科,上海200031

出　　处：《中华眼科杂志》2007年第6期519-524,共6页Chinese Journal of Ophthalmology

摘　　要：目的评价在晶状体悬韧带异常情况下行超声乳化白内障吸除术时植入囊袋张力环（CTR）来提供晶状体囊袋支持的中长期临床效果。方法对2003年1月至2004年7月期间因晶状体悬韧带松弛或部分断裂或合并白内障在我院行超声乳化白内障吸除及CTR和人工晶状体（IOL）植入术的19例患者（22只眼）进行为期2年的随访。随访指标为最佳矫正视力和屈光度数、眼压、CTR和IOL及囊袋复合体的位置、晶状体后囊膜混浊（PCO）和晶状体囊袋的收缩程度。应用眼前节成像系统Pentacam采集各眼的Scheimpflug图像，分析术后1、6、12和24个月IOL的偏心值与倾斜度。结果术后2年随访结果：末次随访最佳矫正视力较术前提高≥2行者20只眼（90.9％），提高1行者2只眼（9．1％）。CTR位置：21只眼CTR位于囊袋内，1只眼CTR部分脱出于囊袋外。IOL位置：22只眼的IOL均位于囊袋内，术后1个月1只眼轻度偏中心，术后2年5只眼轻度偏中心。PCO情况：末次随访3只眼（13．6％）因重度PCO行掺钇钕石榴石激光后囊膜切开，余19只眼为轻度PCO，无需处理。晶状体囊袋收缩程度：末次随访1只眼囊袋中度收缩。Pantacam检查术后1、6、12和24个月IOL的平均偏心值分别为（0．393±0．094）、（0.406±0．094）、（0.415±0．093）、（0.463±0．172）mm，术后1、6与24个月比较，差异有统计学意义（P〈0．05）。倾斜度分别为2．637°±0．369°、2．653°±0．349°、2．682°±0.348°、2．714°±0．360°，各组间差异无统计学意义（P=0.220）。结论CTR合并IOL植入治疗晶状体悬韧带异常可获得良好视力。术后2年的随访观察证实CTR的植入抑制了PCO和囊袋收缩的发生，并维持IOL在囊袋内位置的良好稳定性。（中华眼科杂志，2007．43：519-524）Objective To evaluate the two-year efficacy and stabilization of the capsular tension ring （CTR） in providing capsular support during phacoemulsification in cases of a weak or partially broken ciliary zonule. Methods This prospective study comprised 22 eyes of 19 patients with weakness or partially broken ciliary zonule preoperatively or intraoperatively. After insertion of a CTR, phacoemulsification with intraocular lens （IOL） implantation was performed. Patients were examined preoperatively and postoperatively at 1 day, 1 week, 1, 6, 12 and 24 months. The postoperative refractive status, intraocular pressure, the deeentration of capsule/IOL complex, the degree of posterior capsular opac±fica＇tion （ PCO ） and capsular contraction were examined. The extent of IOL tilting and decentration was measured using Scheimpflug Videophotography System （Pentacam, Oculus ） 1, 6, 12 and 24 months postoperatively. Results Twenty-four months results from this ongoing study indicated that the postoperative best corrected visual acuity improved 2 lines in 20 eyes, improved 1 lines in 2 eyes. In-the-bag fixation of CTR was achieved in 21 eyes （90. 9% ）, CTR of 1 eye is out of capsule bag. IOL implanted was not centered in 1 eye 1 months after surgery and up to 5 eyes 24 months after the surgery. Nd： YAG laser capsulotomy was performed in 3 eyes （ 13. 6% ） by 24 months for severe PCO. The mean IOL decentration was （0. 393 ± 0.094）, （0.406 ±0.094）, （0.415 ±0.093） and（0.463 ±0.172）ram on 1, 6, 12 and 24 months postoperatively, respectively. Significant differences in IOL decentration was presented between 1 and 24 months postoperatively, also between 6 and 24 months. The mean IOL tilt was （2. 637 ±0. 369） , （2. 653 ±0.349）, （2.682±0.348） and （2.714 ±0.360） degrees on 1, 6, 12 and 24 months postoperatively, respectively, which showed no statistically significant differences （ P = 0. 220 ） throughout the 24-month follow-up period. Conclusions CTR offers numerous a

关 键 词：超声乳化 晶体 人工 

分 类 号：R686[医药卫生—骨科学]