应用超声生物显微镜分析虹膜固定折叠人工晶状体的位置  

Ultrasound biomicroscopic analysis of iris-fixated foldable intraocular lens

作　　者：田庆芬[1] 刘景[1] 宋玮[1] 郝琳琳[1] 杜洋洋[1] 张晗[1] 

机构地区：[1]山东大学第二医院,济南250033

出　　处：《中国实用眼科杂志》2013年第4期404-407,共4页Chinese Journal of Practical Ophthalmology

基　　金：山东省医药卫生科技发展计划（2009HZ308）;山东大学自主创新基金（2009TS007）

摘　　要：目的利用超声生物显微镜（UBM）观察虹膜固定后房型人工晶状体的位置，评价手术安全性。方法临床病例对照研究。对2008年2月至2011年2月在山东大学第二医院眼科手术的无足够囊膜支撑的无晶状体眼患者17例17只眼，二期施行虹膜缝合固定后房型人工晶状体（PCIOL）手术，术后6个月行UBM检查，确定人工晶状体与睫状沟和睫状体的关系、前房深度（ACD）、人工晶状体倾斜情况、人工晶状体光学部与虹膜位置关系和房角情况。主要指标是襻的位置、前房深度和房角改变。结果17个人工晶状体的34个襻中，27个（79．4％）襻位于睫状沟，5个（14．7％）襻位于睫状突，2个（5．9％）襻位于睫状体平坦部。17只眼中有11只眼（70．6％）双襻均位于睫状沟。前房深度为（3．39±0．47）mm。未发现虹膜周边前粘连、房角异常和晶状体光学部的倾斜。结论经UBM观察，虹膜缝合固定后房型人工晶状体的襻均位于睫状沟或睫状体，无明显的人工晶状体倾斜。这种术式不影响房角结构，无房角的关闭。前房深度与囊袋内植入人工晶状体最为接近。弄清人工晶状体位置可能有助于确定手术方式、人工晶状体度数计算和减少术后并发症。Objective To observe the position of iris-fixated foldable lens with ultrasound bloml- croscopic （UBM）, and evaluate the safety of the operation. Methods Seventeen patients （17 eyes） who had insufficient posterior capsular support for intraocular lens underwent iris-fixated foldable lens implantation. Six months later, UBM was used to determinate the haptic position in relation to ciliary sulcus and ciliary body, the anterior chamber depth （ACD）, lens tilt, relationship of the IOL optic to iris and angle abnormalities in these eyes. Main outcome measures were haptic position, ACD and iris anatomic changes. Results Of the 34 haptics, 27 （79.4%） were positioned in the cili- ary sulcus, 5 （14.7%） haptics were found over the ciliary processes, and 2 （5.9%） were over pars plana. Both haptics were in the ciliary sulcus in 11 eyes of the 17 eyes （70.6%）. The mean （-4-stan- dard deviation） ACD was （3.84＋0.36） mm. No patients were found to have peripheral anterior syn- echiae, angle abnormalities or tilted lens. Conclusions Iris-sutured PCIOL haptics are found to be in the ciliary sulcus or over the ciliary body with no lens tilt on UBM analysis, The procedure respects the angle anatomy, and no evidence of angle closure is found. The ACD is similar to that of in-the-bag PCIOLs. This may have implications for surgical technique, IOL power calculations, and postoperative complications.

关 键 词：超声生物显微镜 无后囊支撑 后房型人工晶状体 虹膜固定 

分 类 号：R779.66[医药卫生—眼科]