微小切口推注式人工晶状体睫状沟悬吊术临床应用  

Injector implantation of sutured intraocular lens in the absence of capsular support via small-incision surgery

作　　者：陆岩[1] 底煜[1] 陈晓隆[1] 刘鹤南[1] 杨宏伟[1] 

机构地区：[1]中国医科大学附属盛京医院眼科,中国辽宁省沈阳市110004

出　　处：《国际眼科杂志》2013年第2期313-315,共3页International Eye Science

摘　　要：目的:探讨微小切口推注式折叠人工晶状体睫状沟悬吊术的有效性和安全性。方法:选择因晶状体后囊破裂或悬韧带断裂不能正常植入后房型人工晶状体的患者52例52眼,利用推注器系统,通过3.2mm的透明角膜小切口,把襻预扎了聚丙烯缝线的折叠人工晶状体植入后房并缝合固定于睫状沟,观察术后视力、角膜散光度及并发症。结果:所有患者术后裸眼视力均提高,其中1.0以上8眼,0.6～0.8为18眼,0.4～0.6为16眼,0.4以下10眼。术后1wk;1,3mo视力在0.5以上者分别为33眼(63%)、39眼(75%)、41眼(79%)。术前及术后1wk;1,3mo的平均角膜散光度分别为1.86±1.65D,2.09±1.28D,1.92±1.34D和1.77±1.16D,术后各时期与术前的角膜散光度差别均无统计学意义(P>0.05)。术中、术后没有出现严重并发症。结论:微小切口推注式折叠人工晶状体睫状沟悬吊术为治疗晶状体、玻璃体切除术后,无晶状体囊支持的患者,提供了一个更安全可靠的人工晶状体植入方法。AIM：To evaluate the safety and efficacy of a modified technique for transscleral fixation of a foldable posterior chamber intraocular lens （10L） in the absence of capsule support. METHODS; Scleral fixation of a foldable IOL was performed by using a new small incision technique with injector implantation system via 3. 2mm clear corneal incisions in 52 eyes of 52 patients who can not be normally implanted posterior chamber IOL because of posterior capsule rupture or suspensory ligament fracture. Postoperative visual acuity, corneal astigmatism and complications were observed in 6 months follow-up. RESULTS： Postoperative uncorrected visual acuity improved in all patients, of which more than 1. 0 in 8 eyes, 0.6 to0.8 in 18 eyes, 0.4 to0.6 in 16 eyes, less 0.4 in 10 eyes. Postoperative uncorrected visual acuity was at least 0, 5 in 33 eyes （63%）, 39 eyes （75%）, 41 eyes （79%） at postoperative 1 week, 1 month, 3 months respectively. There was no significant difference in corneal astigmatism guided by corneal topography between preoperative and postoperative （ P 〉 0. 05 ）. During follow-up, the IOL was correctly positioned in all cases. There were no major complications, such asendophthalmitis or suture erosion through the conjunctiva at the site of fixation. No patient required further surgical interventions. CONCLUSION： This modified technique of transscleral fixation of foldable posterior chamber IOL offers the advantages of a small incision and rapid visual rehabilitation, and minimizes the risk of intraoperative and postoperative complications.

关 键 词：折叠式后房型人工晶状体 巩膜缝线固定术 推注 系统 透明角膜切口 角膜散光 

分 类 号：R779.6[医药卫生—眼科]