超声乳化联合人工晶状体睫状沟固定治疗马凡综合征晶状体半脱位  

A clinical study of phacoemulsification and foldable intraocular lens implantation with ciliary groove sutured for lens subluxation in Marfan syndrome

作　　者：马红利[1] 李世洋[1] 蒋骁男 胡萌菲[1] 张小牛[1] 

机构地区：[1]解放军150中心医院眼科,河南洛阳471031

出　　处：《中国实用眼科杂志》2014年第5期620-623,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的探讨超声乳化联合折叠式人工晶状体睫状沟固定术治疗马凡综合征晶状体半脱位的安全性及临床疗效。方法收集2006年2月至2012年12月在解放军150中心医院眼科就诊的马凡综合征伴有晶状体半脱位10例（14只眼）患者的临床资料，其晶状体脱位范围〉90°。所有患者均采用超声乳化摘除晶状体，并行后房型折叠式人工晶状体睫状沟缝线固定。随访6—12个月，观察术后视力、眼压、人工晶状体位置及并发症等。结果10例（14只眼）患者均成功完成手术。眼内反应及眼压均在治疗后恢复正常。术后末次随访最佳矫正远视力均≥术前最佳矫正远视力，其中0．05～0．2者2只眼（14．3％），0．25。0．5者8只眼（57．1％），0．6～0．8者4只眼（28．6％）。所有术眼人工晶状体位置均保持不变。无1只眼出现角膜内皮失代偿、脉络膜下出血、缝线外露、眼内炎、继发性青光眼、视网膜脱离或眼球萎缩等严重并发症。结论超声乳化联合折叠人工晶状体睫状沟固定术治疗马凡综合征晶状体半脱位，手术操作损伤小，安全稳定，效果良好。远期效果需要进一步观察。Objective To investigate the security and clinical effect of surgical treatment of phacoemulsification and foldable intraocular lens implantation with ciliary groove sutured for lens sub-luxation in Marfan syndrome. Methods Retrospectively observed clinical data of 14 eyes of lO cas-es suffered from Marfan syndrome with significant lens subluxation. The ranges of lens subluxation in all these eyes were more than 90 degree. All eyes were treated in the way that phacoemulsifica-tion subluxation lens and implantation of a foldable posterior chamber intraocular lens with ciliary groove sutured. Patients were followed up from 6 to 12 months. The visual acuity, intraocular pres-sure, intraocular lens situation and complications were recorded. Results All 10 cases （14 eyes） had successful operations. The intraocular inflammatory reaction and pressure were all recovered to normal after therapy. At the last follow-up time, postoperative best corrected distant visual acuity achieved or over preoperative, in which 2 eyes （14.3%） were from 0.05 to 0.2, 8 eyes （57.1%） were from 0.25 to 0.5, 4 eyes （28.6%） were from 0.6 to 0.8. The intraocular lens was all in the correct situation. There were no severe complications such as corneal endothelial decompensation, sub- choroidal hemorrhage, suture exposure, endophthalmitis, secondary glaucoma, retinal detachment and eyeball atrophy and so on. Conclusions The technique of phacoemulsification and foldable intraocu-lar lens implantation with ciliary groove suture is one of the less harmful, safe and efficient therapy for the patients of Marfan syndrome with significant subluxated lens. The further observation is need-ed for long-term outcome.

关 键 词：马凡综合征 晶状体半脱位 超声乳化术 后房型人工晶状体 睫状沟缝线固定术 

分 类 号：R779.66[医药卫生—眼科]