人工晶状体后囊膜夹持植入治疗儿童无晶状体眼的临床研究  

Posterior capsular retaining during IOL implantation for pediatric aphakia

作　　者：董宏伟[1,2] 

机构地区：[1]邢台市眼科医院 [2]河北省眼病治疗中心,河北省邢台市054001

出　　处：《眼科新进展》2011年第4期376-378,共3页Recent Advances in Ophthalmology

摘　　要：目的探讨应用玻璃体切割头修整后囊孔、行人工晶状体后囊膜夹持植入术治疗儿童无晶状体眼的临床意义。方法收集2005年10月至2008年6月在我院就诊拟行Ⅱ期人工晶状体植入术的无晶状体眼患儿86例156眼,随机分为2组:夹持组44例80眼,应用玻璃体切割头咬切修整后囊孔形成3.5mm×5.5mm椭圆形,行人工晶状体睫状沟植入,下压人工晶状体光学部嵌入后囊孔完成后囊膜夹持;非夹持组42例76眼,常规行人工晶状体睫状沟植入。随访24个月,观察2组术后视力、屈光状态及人工晶状体移位等情况。结果夹持组术后最佳矫正视力0.3-0.5者56眼(70.00%),非夹持组术后最佳矫正视力0.3-0.5者38眼(50.00%),差异有统计学意义(P<0.05)。夹持组人工晶状体移位1眼(1.25%),非夹持组人工晶状体移位21眼(27.63%),差异有统计学意义(P<0.05)。夹持组4眼(5.00%)出现虹膜后粘连,所有术眼均未出现后发性白内障等情况;非夹持组16眼(21.05%)出现虹膜后粘连,4眼(5.26%)出现后发性白内障,差异有统计学意义(P<0.05)。结论儿童无晶状体眼Ⅱ期人工晶状体植入术中将人工晶状体光学部夹持于后囊膜下,可以有效减少术后并发症,避免人工晶状体移位。Objective To evaluate the clinical effects of using vitreous tip to trim posterior capsular hole and taking posterior capsular retaining and intraocular lens（IOL） implantation to cure pediatric aphakia. Methods About 156 eyes of 86 children with pediatric aphakia,who were taken IOL implantation at stage Ⅱ in our hospital from Octomber 2005 to June 2008.All patients were randomly divided into two groups.There were 44 cases（80 eyes） in retaining group,who were using vitreous tip to trim posterior capsular hole and form an elliptic area with 3.5 mm×5.5 mm,and taking IOL implantation and suppressing optical area of IOL to posterior capsular hole to complete posterior capsular retaining;About 42 cases（76 eyes） in non-retaining group,they were commonly taken ciliary groove of IOL implantation.All patients were followed up for 24 months.The best corrected visual acuity,refractive status and dislocation of IOL were observed in both two groups. Results Best corrected visual acuity between 0.3 and 0.5 was 56 eyes in retaining group（70.00%） and 38 eyes in nonretaining group 50.00%）,there was statistically significant difference between the two groups（P〈0.05）;Dislocation of IOL was 1 eye（1.25%） in retaining group,21 eyes（27.63%） in nonretaining group,there was statistically significant difference between the two groups（P〈0.05）;There were 4 eyes（5.00%） with iris synechiae and none with posterior capsule opacification in retaining group,but 16 eyes（21.05%）with iris synechiae and 4 eyes（5.26%）with posterior capsule opacification in nonretaining group,there was statistically significant difference between the two groups（P〈0. 05）. Conclusion Retaining of optical area of IOL into posterior capsule during IOL implantation at stage Ⅱ can effectively decrease postoperative complication and avoid dislocation of IOL.

关 键 词：儿童 无晶状体眼 玻璃体切割头 后囊膜夹持 人工晶状体移位 

分 类 号：R776.3[医药卫生—眼科]