二期后房型人工晶状体植入术治疗外伤性玻璃体切割术后无晶状体眼的疗效观察  

Clinical effects of secondary implantation of intraocular lens for traumatic aphakic eye after pars plana vitrectomy

作　　者：陈平[1] 

机构地区：[1]宜宾市第二人民医院眼科,四川省宜宾市644000

出　　处：《眼科新进展》2013年第5期463-465,共3页Recent Advances in Ophthalmology

摘　　要：目的观察二期后房型人工晶状体植入术治疗外伤性玻璃体切割术后无晶状体眼的疗效。方法收集2008年5月至2010年5月我院眼科收治的无晶状体眼患者75例(75眼),根据患者晶状体囊膜情况选择不同操作及人工晶状体植入,晶状体囊膜保留完整者选择植入一片式折叠PMMA后房型人工晶状体,晶状体囊膜完全缺损或残留不能利用者选择植入悬吊式PMMA后房型人工晶状体。术后随访3～9个月,平均5.5个月。观察患者随访末期视力、眼压、晶状体位置及并发症情况,同时检测患者角膜内皮细胞密度。结果二期术前患者裸眼视力≤0.1者42眼,0.1～0.3者21眼,≥0.3者12眼;二期术后全部患者裸眼视力均有不同程度提高,其中≤0.1者14眼,0.1～0.3者26眼,≥0.3者34眼;差异有显著统计学意义(P<0.01)。二期术前所有患者眼压均在正常范围内,术后13例患者出现一过性高眼压,眼压范围为25～40mmHg(1kPa=7.5mmHg),经治疗1周后眼压均控制在正常范围内。至随访末期,68例(90.7%)患者人工晶状体位置居中,4例(5.3%)人工晶状体偏心,3例(4.0%)人工晶状体倾斜。术中8例出现轻度前房出血,6例出现轻度角膜水肿。结论二期后房型人工晶状体植入术治疗外伤性玻璃体切割术后无晶状体眼有效可行,并能较好提高患眼视力。Objective To observe the clinical effects of secondary implantation of intraocular lens for traumatic aphakic eye after pars plana vitrectomy. Methods There were 75 patients（75 eyes） chosen with traumatic aphakic eye from May,2008 to May,2010 in our hospital. Based on the lens capsule preserving or not in the frost surgery, different methods of operation were taken and different types of intraocular lens were implanted. For the patients preserving the lens capsule, the PMMA piece foldable posterior chamber intraocular lens were implanted, and for the patients not preserving the lens capsule or having the entirely damaged lens capsule, the PMMA suspension foldable posterior chamber intraocular lens were implanted. The follow-up time after the operation was from 3 months to 9 months（5.5 months at average）. The visual acuity,intraocular pressure,lens location and complication at the final follow up were observed, and the corneal endothelial cell density was detected. Results There were substantially different improvement in naked visual acuity at the pre-operation and post-operation. At the pre-operation, there were 42 patients with naked visual acuity 〈0.01,32 patients with naked visual acuity from 0.1 to 0.3,12 patients with naked visual acuity 〉 0.3, while at the post-operation, there were 14 patients with naked visual acuity 〈 0.01,26 patients with naked visual acuity from 0.1 to 0.3,34 patients with naked visual acuity 〉 0.3. The changes were substantially statistical significant. At the pre-operation,intraocuiar pressure of all patients were from 25 mmHg to 40 mmHg（ 1 kPa =7.5 mmHg） ,which at postoperative 1 week later were all in normal. At the final follow-up, the position of the implanted intraocuiar lens include center for 58 eyes（90.7% ） ,decentration for 4 eyes（5.3% ） ,tilt for 3 eyes（4.0% ）. At the intra-operation,the main complications in two groups were corneal edema occurred in 8 eyes, iris damage and posterior capsule rupture occurred in 6 eyes. Conesion Secondary imp

关 键 词：人工晶状体植入术 玻璃体切割术 无晶状体眼 

分 类 号：R776.1[医药卫生—眼科]