晶状体囊袋张力环脱位的手术治疗  

A study on the management of dislocated capsular tension rings

作　　者：史翔宇[1] 庞秀琴[1] 何雷[1] 卢海[1] 王绍莉[1] 

机构地区：[1]首都医科大学附属北京同仁医院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

出　　处：《眼科》2012年第2期82-85,共4页Ophthalmology in China

摘　　要：目的探讨晶状体囊袋张力环（CTR）完全脱位的治疗效果。设计回顾性病例系列。研究对象2006年3月至2010年2月北京同仁医院治疗的CTR完全脱位患者11例（11眼）。方法所有患者先行玻璃体切除联合脱位CTR取出,再根据视网膜和视盘情况以及取出的CTR和人工晶状体（IOL）状况,分别选择IOL或CTR缝线固定7眼,虹膜固定型IOL植入1眼,硅油填充3眼。术后随访5~32个月。主要指标视力、眼压、IOL居中性及并发症。结果 11眼均顺利取出脱位的CTR和IOL,8眼同时植入IOL,3眼行硅油填充。最后一次随访时最佳矫正视力0.3~0.6者4眼,0.1~0.2者4眼,低于0.1者2眼,1例患者不合作。其中5眼达到或超过CTR脱位前的最好矫正视力。术后高眼压5眼,眼压25~51 mm Hg。4眼经药物治疗,1眼经巩膜睫状体光凝后眼压恢复正常。前房积血1眼,经药物治疗后吸收。未出现IOL或IOL-CTR复合体脱位或偏位现象。结论玻璃体切除联合脱位CTR取出并睫状沟缝线固定IOL或CTR可以有效地治疗CTR完全脱位。Objective To evaluate the treatment efficacy of dislocated capsular tension rings（CTR）.Design Retrospective cases series.Participants 11 cases（11 eyes） of complete CTR dislocation underwent surgical management were evaluated retrospectively in Beijing Tongren Hospital from March 2006 to February 2011.Methods All the 11 cases were given to vitrectomy and removed the dislocated capsular tension rings.Then procedures for repairing were pertormed including scleral suture fixation of the IOL haptics or the CTR through the complex（7 cases）,iris fixation of the IOL（1 case）,or silicone oil tamponade（3 cases）,respectively.The follow-up period varied from 5 to 32 months.Main Outcome Measures Visual acuity,intraocular pressure,IOL location and surgical complications.Results The dislocated CTR was removed successfully in all 11 cases.Of the 11 patients,8 had intraocular lens implantation,3 had silicone oil tamponade.At the last follow-up after surgery,the visual acuity was 0.3 ~0.6 in 4 eyes,0.1~0.2 in 4 eyes,and less than 0.1 in 2 eyes,one patient（1 eye） incapability for visual acuity assessent.On postoperative day 2 to 5,ocular hypertension occurred in 5 eyes（ranging from 25 to 51 mm Hg）.The intraocular pressure returned to normal with medications in 4 eyes and transscleral cyclophotocoagulation in 1 eye,respectively.One eye involved hyphema in the immediately postoperation,and absorbed after using medications.There were no postoperative re-dislocation and decentration of the CTR-IOL complex or IOL.Conclusion Complete CTR dislocation may be effectively managed with a pars plana vitrectomy and a scleral suture fixation of the IOL or the CTR.

关 键 词：晶状体半脱位/外科学 晶状体囊袋张力环 手术后并发症 玻璃体切除术 

分 类 号：R779.6[医药卫生—眼科]