囊袋内植入的人工晶状体半脱位的治疗研究  

Treatment of in-the-bag intraocular lens subluxation

作　　者：史翔宇[1,2] 卢海[1,2] 齐梦[1,2] 王绍莉[1,2] 于洁[1,2] 郑鹏飞[1,2] 何雷[1,2] 

机构地区：[1]首都医科大学附属北京同仁医院 [2]北京同仁眼科中心眼科学与视觉科学北京市重点实验室,100730

出　　处：《眼科》2014年第4期264-267,共4页Ophthalmology in China

基　　金：首都医科大学基础临床科研合作基金(12JL48)

摘　　要：目的探讨囊袋内人工晶状体（IOL）半脱位的治疗方法和安全性。设计回顾性病例系列。研究对象2009年2月至2013年2月北京同仁眼科中心19例（19眼）囊袋内IOL半脱位的患者。方法回顾上述患者的病历资料。依据IOL类型和半脱位程度分别予以IOL置换缝线固定和经囊袋单纯缝线固定复位术。主要指标手术方法、视力、并发症。结果19例患者均顺利完成手术。5例（26．3％）为IOL置换，取出原IOL，选用新IOL以缝线固定于巩膜；14例（73．7％）为IOL单纯缝线固定复位，将脱位的IOL襻固定于巩膜。术后随访5～41个月。最后一次随访时，视力均≥0．3，其中≥0．8者8例（42．1％）。术后第1天7例（36．8％）出现轻度前房或玻璃体积血。术后第1周内3例（15．8％）出现高眼压，经滴眼液治疗后恢复正常。3例（15．8％）出现IOL轻度偏心，4例（21．1％）IOL轻度倾斜，均未处理。结论采用IOL置换缝线固定或经囊袋单纯缝线固定复位的方法治疗囊袋内IOL半脱位有效而安全。Objective To study the surgical methods and their safety of in-the-bag IOL subluxation. Design Retrospective case series. Participants 19 cases （19 eyes） were enrolled with the diagnosis as in-the-bag IOL subluxation in Beijing Tongren Eye Center from Feb 2009 to Feb 2013. Methods Review the above cases. IOL exchange with suture fixation surgery or transcapsule IOL suture fixation reposition surgery was performed according to the IOL type and the severity of the IOL subluxation. Main Outcome Measures Surgical method, visual acuity, postopergtive complications. Results All 19 cases went through surgical treatment smoothly： 5 cases （26.3%） by IOL exchange with suture fixation surgery in which the dislocated IOL was removed and replaced with transscleral sutured posterior chamber IOL; other 14 cases （73.7%） by transcapsule IOL suture fixation reposition surgery in which the dislocated haptics were sutured to the sclera. The postoperative follow-up lasted for 5 to 41 months. At the last visit, postoperative visual acuity ≥0.3 in all 19 cases,≥0.8 in 8 cases （42.1%）. Mild hyphema or vitreous hemorrhage occurred in 7 cases （36.8%） in the first day after surgery. Hy- pertension occurred in 3 cases （15.8%） during the first week after surgery. IOP all went back to normal after eye drop treatment. Slight decentration of IOL occurred in 3 cases （15.8%）. Slight tilt of IOL occurred in 4 cases （21.1%）. These 7 cases were remained untreated with observation. Conclusion IOL exchange with suture fixation surgery and transeapsule IOL suture fixation reposition surgery are el-fective and safe surgical solutions to postoperative in-the-bag IOL subluxation.

关 键 词：人工晶状体 半脱位 手术后并发症 

分 类 号：R779.6[医药卫生—眼科]