闭合式睫状沟缝线固定治疗人工晶状体不全脱位的长期疗效观察  

The long-term effection observation about closed ciliary sulcus suture fixation treating intraocular lens subluxation

作　　者：于芳蕾[1] 罗肇文[1] 王岳秀[1] 段辉[1] 

机构地区：[1]大连医科大学附属第一医院眼科,辽宁大连116011

出　　处：《中国实用眼科杂志》2015年第9期1034-1037,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的 探讨闭合式睫状沟缝线固定治疗人工晶状体不全脱位的长期安全性和有效性.方法 临床病例系列研究.回顾性分析2008年至2012年在大连医科大学附属第一医院眼科收治的人工晶状体不全脱位患者19例,行闭合式睫状沟缝线固定方法将原人工晶状体复位.对术后3d及术后2年视力、最佳矫正视力、眼压、角膜内皮细胞计数、角膜散光等进行统计学分析.结果 术前视力0.22±0.10,最佳矫正视力0.71±0.18,角膜散光（0.76±0.29）D,眼压（16.21±4.29） mmHg,角膜内皮细胞计数（2225.58±439.53）个/mm2.术后3d视力0.69±0.14,,最佳矫正视力0.83±0.16,眼压（17.53±5.07） mmHg.术后2年视力0.80±0.15,最佳矫正视力0.89±0.14,眼压（16.37±4.87） mmHg,角膜内皮细胞计数（2084.79±434.06）个/mm2,角膜散光（0.78±0.33）D.视力、最佳矫正视力术后3d、术后2年较术前差异有统计学意义（t =-14.90,P＜0.01,t=-5.40,P＜0,01;t=-16.13,P＜0.01,t =-6.42,P＜0.01）,角膜内皮细胞计数术后2年与术前差异有统计学意义（t=-6.0,P＜0.01）,但无内皮细胞功能失代偿.眼压、角膜散光术后2年与术前比较差异无统计学意义（t =-0.25,P=0.80;t =-0.91,P=0.375）.结论 闭合式睫状沟缝线固定治疗人工晶状体不全脱位避免了人工晶状体更换所需的扩大切口及缝合带来的散光和剪断人工晶状体襻等操作对周围组织的扰动,减少了眼前段手术操作,损伤小,视力恢复快,安全有效,但更长期的安全性有待于更多数量的病例证实。Objective To discuss the long-term safety and efficacy of closed ciliary sulcus suture fixation treating intraocular lens subluxation.Methods A retrospective case-observation study.Selected 19 patients with intraocular lens subluxation in our eye center from 2008 to 2012, the original intraocular lens reset by using closed ciliary sulcus suture fixation were performed.Preoperative and postoperative visual acuity （VA）, best corrective visual acuity （BCVA）, intraocular pressure （IOP）, corneal endothelial cell counting and comeal astigmatism were measured and documented.Results The preoperative VA 0.22 ±0.10, BCVA 0.71±0.18, corneal astigmatism （0.76±0.29）D, IOP （16.21±4.29） mmHg, comeal endothelial cell counting （2225.58±439.53）/mm2.The postoperative 3 days VA 0.69±0.14, BCVA 0.83±0.16, IOP （17.53±5.07）mmHg.The postoperative 2 years VA 0.8± 0.15, BCVA 0.89±0.14, IOP （16.37±4.87）rnmHg, corneal endothelial cell counting （2084.79±434.06）/ mm2, corneal astigmatism （0.78±0.33） D.VA and BCVA of postoperative 3 day and 2 years were obviously improved Compared with that of preoperative （t =-14.90, P 〈0.01, t =-5.40, P 〈0.01;t =-16.13, P 〈0.01, t =-6.42, P 〈0.01）.There was significant difference in corneal endothelial cell counting（t =-6.0, P 〈0.01）, and no significant difference in intraocular pressure and corneal astigmatism between preoperation and postoperative 2 years（t =-0.25, P =0.80;t =-0.91, P =0.375）.Conclusions The closed ciliary sulcus fixation treating intraocular lens subluxation can avoid corneal astigmatism by enlarging incision when IOL renewed.This method also can lead less disturbance of adjacent tissue.Although this method is little injury, fast recovery of visual acuity, safe and effective,we also need more cases to confirm the longer-term security.

关 键 词：人工晶状体不全脱位 睫状沟缝线固定 

分 类 号：R776.1[医药卫生—眼科]