先天性晶状体半脱位手术治疗临床研究  

Surgical treatment of congenital subluxated lenses----a random controlled clinical trial

作　　者：薛文娟[1] 宋旭东[1] 闫岩[2] 杨文利[1] 钱进[1] 

机构地区：[1]首都医科大学附属北京同仁医院眼科中心,北京同仁眼科中心,北京市眼科学与视觉科学重点实验室,100730 [2]首都医科大学生物医学工程学院

出　　处：《中国实用眼科杂志》2010年第6期615-618,共4页Chinese Journal of Practical Ophthalmology

基　　金：首都医科大学基础-临床科研合作基金资助（09JC33）

摘　　要：目的 比较囊袋内张力环（CTR）植入术和人工晶状体（IOL）巩膜缝合固定术治疗先天性晶状体半脱位的有效性及安全性.方法 将2008年6月至2009年10月就诊的27例（45只眼）年龄3～50岁的先天性晶状体半脱位患者,随机分为两组,分别采用CTR植入并二期CTR固定术（24只眼）与IOL巩膜缝合固定术（21只眼）治疗,术后观察视力、最佳矫正视力（BCVA）、散光等指标,术后3个月行前节OCT及晶状体后照法测量IOL的倾斜及偏心值,记录手术并发症.结果 术后3个月,最佳矫正视力CTR组为0.75,IOL固定组为0.54;散光度数CTR固定后为1.47D,IOL固定组为2.35D;CTR固定后IOL倾斜为5.48°,IOL固定组IOL倾斜为7.37°;两组术后BCVA、散光、IOL倾斜度数的差异均有统计学意义（P〈0.05）：CTR固定后IOL偏心为1.09mm,IOL固定组IOL偏心为0.88mm,差异无统计学意义（P〉0.05）.IOL固定组4只眼IOL夹持.结论 超声乳化晶状体吸除联合囊袋内CTR和IOL植入、二期CTR巩膜缝合固定术是治疗先天性晶状体半脱位的更好选择.Objective To compare the efficacy and safety of two surgical options in treating congenital subluxated lenses,one is capsular tension ring（CTR）and intraocular lens（IOL）implantation,and the other is IOL scleral fixation.Methods This study comprised 45 eyes of 27 congenital subuxated lenses patients,who were randomly divided into two groups.In Group 1（n=24 eyes）,a CTR and IOL was implanted and in Group 2（n=21 eyes）,a single-piece,scleral-fixated IOL.For group 1,CTR was sutured to sclera at a secondary surgery two months after CTR and IOL implantation.The postoperative visual acuities and best corrected visual acuities（BCVAs）,astigmatism were analyzed.IOL tilt and decentration were measured with AC-OCT system and IOL post-photo system 3 months after surgery.Results Three months after surgery,Compared to group 2,group 1 had better BCVA（0.75 vs 0.54,P〈0.05）,lower astigrnatism（1.4D vs 2.3D,P〈0.05）.smaller IOL tilt（5.48°vs 7.37°,P〈0.05）.IOL decentration was 1.09mm in group 1 and 0.88mm in group 2 but without significant differences statistically （P〉0.05）.IOL pupillary capture occurred to 4 eyes of group 2.Conclusions Phacoemulsification with CTR and IOL implantation combined with secondary CTR scleral fixation iS a better surgical option for congenital subluxated lenses.

关 键 词：晶状体半脱位 囊袋张力环 人工晶状体 

分 类 号：R776[医药卫生—眼科]