不同襻设计的人工晶状体应用于联合手术的对比性研究  

Comparative study on different haptic designs of intraocular lenses in combined surgery

作　　者：许立帅[1] 李文生[2] 吴荣瀚[2] 王新丹[2] 赵立娟[2] 郑钦象[2] 

机构地区：[1]川北医学院附属医院眼科,四川省南充市637000 [2]温州医学院附属眼视光医院,浙江省温州市325027

出　　处：《眼科新进展》2008年第9期679-682,共4页Recent Advances in Ophthalmology

摘　　要：目的探讨2种不同襻设计的人工晶状体应用于白内障超声乳化摘出联合玻璃体切割及人工晶状体植入术(简称"联合手术")治疗玻璃体视网膜疾病合并白内障的临床疗效。方法回顾性分析联合手术治疗玻璃体视网膜疾病合并白内障患者52例54眼,AkreosAdapt组(4襻)26例28眼,C-flex组(双襻)26例26眼,术后定期随访,并观察视力、人工晶状体囊袋稳定性及手术并发症。结果术后随访10～18个月,平均(14.6±3.8)个月,术后最佳矫正视力:AkreosAdapt组提高22眼,C-flex组提高20眼,组间比较差异无统计学意义(Z=-0.13,P>0.05)。IOL偏心量:AkreosAdapt组:0级15眼,1级8眼,2级4眼,3级1眼;C-flex组:0级8眼,1级7眼,2级9眼,3级2眼,组间比较差异有统计学意义(Z=-2.00,P<0.05)。2组人工晶状体预防后发性白内障的组间比较差异无统计学意义(Z=-0.88,P>0.05)。手术主要并发症包括角膜水肿、前房纤维素性渗出、继发性青光眼等,组间比较差异均无统计学意义(P>0.05)。结论2种不同襻设计的人工晶状体应用于联合手术治疗玻璃体视网膜疾病合并白内障安全、可行。4襻AkerosAdapt人工晶状体的囊袋稳定性优于双襻C-flex人工晶状体,2种人工晶状体预防后发性白内障的作用有待于长期观察。Objective To evaluate clinical outcomes of using two foldable intraocular lenses （IOL） with different haptic designs （Akreos Adapt and C- flex） for combined therapy, which included phacoe- mulsiflcation, pars plana vitrectomy （PPV） and IOL implantation, in patients with coexisting vitreoretinal disease and cataract. Methods Retrospective study was carried out in 52 patients （ 54 eyes ） with coexisting vitreoretinal disease and cataract after combined therapy. Akreos Adapt group with four-point haptic design was 26 cases （ 28 eyes ）, and C-flex group with two-point hal）tic design was 26 cases （26 eyes ）. Bestcorrected visual acuity （ BCVA）, stability of IOL, and complicatioas were evahtated, and a regular follow-up was taken after surgeD,. Results The mean followup time was（ 14.6 ± 3.8 ） months ranging from 10 to 18 months. BCVA improved at 22 eyes in Akreos Adapt group,mid hnproved at 20 eyes in C-flex group. There was no significant difference with the value of BCVA between tow groups （ Z = - 0.13, P 〉 0.05 ）. IOL decentration in Akreos Adapt group was 15 eyes with grade 0,8 eyes with grade 1,4 eves with grade 2 and 1 eye with grade 3;While IOL decentration in C-flex group was 8 eyes with grade 0,7 eyes with grade 1,9 eyes with grade 2.2 eyes with grade 3. No statistical signifi-cance was found between two groups （ Z = - 2. 00, P 〈 0. 05 ）. The groups did not differ with the effect of preventing the rates of after-cataract （ Z = - 0. 88 ,P 〉 0. 05 ）. There was significant difference with complications between two groups, such as corneal edema, anterior chamber fibrinous exudation, and secondary glaucoma（P〉0.05）. Conclusions Both of the Akreos Adapt IOL and C-flex IOL are feasible for combined therapy, which included phacoemulsification, PPV and IOL implantation, in patients with coexisting vitreoretinal disease and cataract. The stability of IOL with Akreos-Adapt is slightly better than that with C-flex. It＇ s necessary for long thne observation of bot

关 键 词：白内障超声乳化 玻璃体切割 人工晶状体 后发性白内障 

分 类 号：R779.66[医药卫生—眼科]