超声乳化吸出联合人工晶状体植入术治疗晶状体半脱位的技术探讨  

Surgical treatment of subluxated lens by intraocular lens implantation shift to an earlier time replacing capsular tension ring during phacoemulsification

作　　者：俞晓艺[1] 赵岐[1] 王星[1] 林郁[1] 

机构地区：[1]中国广东省中山市人民医院暨中山大学附属中山医院眼科,528403

出　　处：《国际眼科杂志》2009年第7期1276-1278,共3页International Eye Science

基　　金：中国广东省中山市科技计划资助项目(No.2009010)~~

摘　　要：目的:探讨在超声乳化联合人工晶状体植入手术中,采用经过改良后的方法替代囊袋张力环(capsular tension ring,CTR)方法治疗晶状体半脱位的可行性。方法:将2006-09/2009-01在我院治疗的晶状体半脱位患者33例34眼随机分为两组,一组为改良超声乳化组16例17眼,行改良的超声乳化白内障吸出联合人工晶状体植入术,术中重点在超声乳化吸出部分晶状体核后提前植入人工晶状体(部分患者酌情缝线固定)替代CTR,然后继续手术;另一组为CTR组17例17眼,行常规超声乳化白内障吸出联合人工晶状体植入术,术中植入CTR。对两组患眼术后疗效和并发症进行比较。结果:所有34眼均顺利完成手术。手术后两组患者人工晶状体正位率无显著性差异(χ2=0.37,P>0.05)。手术后两组患者最佳矫正视力均较手术前明显提高(χ2改良超声乳化组=13.24,P<0.05;χ2CTR组=17.69,P<0.05),两组患者手术后最佳矫正视力无显著性差异(χ2=0.71,P>0.05)。两组患眼术中均未见严重或特殊并发症,术后反应无显著性差异(χ角2膜水肿=0.47,χ前2房渗出=1.21,χ2高眼压=0.18,χ2后囊膜混浊=0.24,P>0.05)。结论:在超声乳化治疗晶状体半脱位的手术中,采用中期提前植入人工晶状体替代CTR的方法是安全有效的,能提高手术安全性,防止人工晶状体偏位,减少手术并发症,降低手术成本及植入异物的风险。AIM To explore the feasibility of capsular tension ring （ CTR ） replacement with improved method during phacoemulsification combined with intraocular lens （IOL） implantation in treatment of lens subluxation. METHODS. Thirty-three cases （34 eyes） with lens subluxation from september 2006 to january 2009 were divided into two groups at random. The first group including 16 cases 17 eyes was performed earlier time IOL implantation instead of CTR during phacoemulsification. The second group including 17 cases 17 eyes underwent phacoemulsification with CTR. The results of the two groups were compared and analyzed. RESULTS. All 34 eyes received surgery successfully. After operation, there were no significant differences in the right position ratio of lens between two groups（Χ^2 = 0.37, P 〉 0.05）. Best corrected visual acuity （BCVA） of all 34 eyes postorerativelly improved significantly compared to that of preoperation（Χfirst group^2 = 13.24, P〈 0.05; Χsecond group ^2= 17.69,P〈 0.05） ,and there were no significant differences in the two groups. There were no serious complications during operation and no significant differences after operation between two groups （ Χcorneal ederna ^2= 0. 47, Χanterior chamber exudation^2=1. 21,Χhigh intraocular pressure^2= 0. 18, Χposterior capsular opacification^2= 0.24, P 〉 0.05）. CONCLUSION. It is safe and efficient to replace capsular tension ring （ CTR ） with improved method during phacoemulsification combined with intraocular lens （IOL） implantation in treatment of lens subluxation.

关 键 词：晶状体半脱位 超声乳化 人工晶状体 囊袋张力环 

分 类 号：R779.6[医药卫生—眼科]