小切口经虹膜缝线固定后房型人工晶状体植入术治疗无晶状体眼  

Iris suture fixation of foldable posterior chamber intraocular lenses with small incision for aphakic eyes

作　　者：王勇[1] 叶应嘉[1] 鲍先议[1] 周龑丽[1] 许荣[1] 彭婷婷[1] 余天[1] 

机构地区：[1]武汉爱尔眼科医院,湖北省武汉市430063

出　　处：《眼科新进展》2012年第5期454-457,共4页Recent Advances in Ophthalmology

摘　　要：目的评价小切口经虹膜缝线固定后房型人工晶状体植入术治疗无晶状体眼的临床效果。方法对17例(17眼)因无晶状体眼而行折叠式后房型人工晶状体经虹膜缝线固定术的患者进行回顾性分析。手术方法为经3.0mm透明角膜切口,植入三片式折叠后房型人工晶状体,采用Siepser术式缝合虹膜的方法将人工晶状体的双襻以10-0聚丙烯缝线分别缝合固定于中周部虹膜。记录患者术前与术后裸眼远视力、最佳矫正远视力、眼压、术前及术后角膜内皮细胞计数、人工晶状体位置(偏心度、倾斜度、稳定性),及术中与术后并发症等情况,随访3～18个月。结果所有病例均顺利经虹膜缝线固定人工晶状体。术后1个月裸眼远视力均等于或高于术前最佳矫正远视力。术后1个月眼压均在正常范围内。术后人工晶状体位置3例(17.6%)偏心,无人工晶状体倾斜病例。术中前房出血2例,均为少量,于术后1周内吸收;角膜轻度水肿4例,均在术后1周内透明。术后4例瞳孔近圆形,未见脉络膜脱离及玻璃体积血等并发症发生。结论折叠式后房型人工晶状体经虹膜缝线固定术治疗无晶状体眼操作便捷,手术切口小,术中及术后并发症少,但远期效果有待进一步观察。Objective To evaluate the clinical outcomes of iris suture fixation of a foldable posterior chamber intraocular lens（PC IOL） with small incision for aphakic eyes.Methods Seventeen cases（17 eyes） underwent an iris suture fixation of a foldable PC IOL were reviewed.Surgical technical was similar to iris suture repair which has been described by Siepser.PC IOL was implanted through 3.0 mm clear corneal incision,and Siepser sutures were used to fix each of the haptics to the peripheral iris with 10-0 polypropylene.The preoperative and postoperative uncorrected distant visual acuity,best corrected distant visual acuity,intraocular pressure,corneal endothelial cells counting and location of PC IOL were recorded.Intraoperative and postoperative complications were observed.The follow-up was from 3 months to 18 months.Results All cases were successfully received iris suture fixation of a foldable PC IOL.The postoperative uncorrected distant visual acuity at 1 month was equal to or better than preoperative best corrected distant visual acuity.The postoperative intraocular pressure was all in normal range.Three cases had postoperative IOL dislocations,no IOL with obliquity.The transient anterior chamber hemorrhage appeared in 2 cases,and absorbed in postoperative 1 week;The slight corneal edema appeared in 4 cases,and cleared in postoperative 1 week.An oval shape pupil was in 4 cases,no choroidal detachment and vitreous hemorrhage happened.Conclusion Iris suture fixation of foldable PC IOL with small incision for aphakic eyes is convenient with few intraoperative and postoperative complications,but the long-term effect should be further observed.

关 键 词：人工晶状体 虹膜 缝线固定术 无晶状体眼 后房型 

分 类 号：R776.1[医药卫生—眼科]