固定孔型囊袋张力环在大范围晶状体脱位白内障手术中的应用  

The application of scleral-fixed capsule tension ring insertion in eye with large traumatic zonular dialysis.

作　　者：李灿[1] 陈潇[1] 廖琼[1] 刘翔[1] 

机构地区：[1]第三军医大学西南眼科医院,重庆市400038

出　　处：《中华眼外伤职业眼病杂志》2012年第1期10-12,共3页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的探讨固定孔型囊袋张力环在晶状体大范围脱位白内障手术中的应用价值。方法对13例（14眼）白内障并伴有〉180°晶状体脱位患者行白内障手术，其中3例（3眼）玻璃体脱出前房者先行前部玻璃体切除后环形撕囊；8例（8眼）应用虹膜拉钩固定脱位处前囊。行晶状体超声乳化吸出或囊外摘出术，将囊袋张力环（CTR）固定孔穿过聚丙烯缝线固定于脱位侧巩膜上，抽吸晶状体皮质后植入折叠式人工晶状体。5例（6眼）同时行瞳孔成形术。结果术后随访3～12个月，最佳矫正视力〈0．3者1眼（7．1％），0．3～0．5者4眼（28．6％），0．6～1．0者9眼（64．3％）。术后散光明显减轻，与术前比较差异有统计学意义。UBM提示所有的人工晶状体均正位无偏斜。结论对于晶状体大范围脱位者应用固定孔型囊袋张力环有利于囊袋完整及人工晶状体植入，防止人工晶状体偏位，获得良好的视力恢复。Objective To investigate the long-term effect of scleral-fixed capsule tension ring （CTR） insertion in eyes with large traumatic zonular dialysis that underwent phacoemulsification with intraocular lens（IOL） implantation into the capsule. Method This prospective study included 14 eyes of 13 patients with cataract and large traumatic zonular dialysis（ 〉 180° ）, For 3 cases which vitreous came out into anterior chamber we performed anterior vitrectomy first. In 8 cases, we used iris hooks to fix anterior capsule. All cases were performed cataract surgery, sutured the CTR on the sclera, aspirated the cortes, then implanted the intraocular lens into the capsule. 6 cases were performed coreoplasty at same time. Best corrected visual acuity （BCVA）, intraocular pressure （lOP） , astigmatism pre -and post-operative periods and postoperative IOL decentration were recorded. Result The follow-up period was range from 3 to 12 months, BCVA0.6-1.0 on nine eyes（64.3%） , 0.3-0.5 on four eyes （28.6%） , 〈0.3 on only 1 eye （7.1% ）. Astigmatism decreased after surgery with significant statistical difference. UBM showed no IOL was found to be decentrated at the end of the follow-up period. Conclusion Scleral-fixed CTR is useful in the cataract surgery in cases with large range lens luxation, it helps to keep the capsule integral, prevent the intraocular lens deviate, and gain good vision for the patients.

关 键 词：囊袋张力环 晶状体脱位 缝线固定 

分 类 号：R779.66[医药卫生—眼科]