25G前灌注联合折叠推注型IOL无结膜切口悬吊术在术后无晶状体眼治疗中分析  

Minimally invasive sutured intraocular lens placement without conjunctival incision in aphakic post-vitrectomy eyes via 3mm incision and 25G anterior-irrigation

作　　者：郑科 刘学群[2] 程昕 杨承勋 

机构地区：[1]北京爱尔英智眼科医院,100021 [2]南昌爱尔眼科医院,330000

出　　处：《中国实用眼科杂志》2014年第10期1197-1201,共5页Chinese Journal of Practical Ophthalmology

摘　　要：目的 探讨25G前灌注联合折叠推注型人工晶状体（IOL）微创悬吊术治疗玻璃体切割（简称玻切）术后无晶状体眼的手术技巧、疗效及注意事项.方法 对2011年10月至2013年9月在爱尔英智眼科医院,就诊的20例（21只眼）玻切术后无晶状体眼,行25G前灌注联合折叠推注型IOL微创悬吊术进行回顾性分析,术前、后观察裸眼视力、最佳矫正视力、屈光状态、角膜内皮细胞密度及IOL位置和并发症发生情况.结果 术后随访3-24月,手术除1例因IOL误装引起IOL前襻损伤而重新植入外,其余手术均一次性顺利植入,术中术后无严重并发症,术前裸眼视力为指数/眼前-0.1,术后3月裸眼视力为0.1～1.0,术前最佳矫正视力为0.51±0.30,术后3个月的最佳矫正视力为0.52±0.27,两者差异无统计学意义（P =0.379＞0.05）,术后3月裸眼视力为0.50±0.28,与术前最佳矫正视力相比差异无统计学意义（P =0.526 ＞0.05）.术后轻度偏中心2只眼,轻度倾斜2只眼,余IOL位置居中.结论 该术式角巩膜缘巩膜瓣无需打开结膜,创伤小,术后恢复较快,在25 G前灌注保护下,经3 mm切口缝合植入折叠注入式IOL,避免了术中眼压波动、易出血、术后切口愈合慢、散光大的缺点,术毕切口自闭,无需缝合,避免了以往25 G后灌注切口渗漏所引起的术后低眼压,安全有效、创伤小、无须缝合、无结膜瘢痕、术后恢复快等优点,为患者提供了较好地术后裸眼视力,提高了患者的视觉质量.Objective To evaluate the therapeutic efficacy of minimally invasive sutured intraocular lens placement without conjunctival incision in aphakic post-vitrectomy eyes via 3mm incision surgery and 25G anterior-irrigation.Methods Twenty patients（21 eyes）were aphakic post-vitrectomy eyes.Before the operation,the uncorrected distance visual acuity was from counting fingers to 0.1,and the best corrected visual acuity was from 0.1 to 1.0,All cases were performed the surgery which a Akreos foldable IOL was used to facilitate 2-point fixation through a 3mm incision,with 25G anterior-irrigating without conjunctival incision.Post-operation uncorrected visual acuity,best corrected visual acuity,IOP,diopter,IOL location and complication were observed.Results Followed-up 3-24 months post-operation,uncorrected VA was from 0.1-1.0,better than pre-operation,uncorrected VA and best corrected VA were both similar to pre-operation（P =0.526〉0.05,P =0.379〉0.05）.Seventeen IOLs were good centration,2 IOLs with gently dislocation,2 IOLs with gently tilt and no one with the uncomfortable complains.Conclusions With 25 G anterior-irrigating,minimally invasive sutured intraocular lens placement without conjunctival incision in aphakic post-vitrectomy eyes via 3mm incision surgery is a safe,efficient and simple surgery,with small wound and recovery soon,no conjunctival scar.It provides good uncorrected visual acuity.

关 键 词：无晶状体眼 叠型人工晶状体 玻璃体切割术 人工晶状体植入25 G前灌注 微创 

分 类 号：R775.05[医药卫生—眼科]