晶状体不全脱位术中虹膜拉钩囊袋张力环的应用  

Application of iris retractor and capsular tension ring in the operation for subluxation of lens

作　　者：杜珊珊[1] 张凤妍[1] 刘京婧[1] 

机构地区：[1]郑州大学第一附属医院眼科,450052

出　　处：《中华眼外伤职业眼病杂志》2015年第12期890-893,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的评价晶状体不全脱位（subluxation of lens）以虹膜拉钩和囊袋张力环辅助进行超声乳化手术的临床效果。方法对20例（20只眼）外伤性白内障伴晶状体不全脱位进行超声乳化手术，术中于连续环形撕囊后用虹膜拉钩从角膜缘穿刺口进入拉住脱位的撕囊口边缘，超声乳化吸出晶状体核和皮质后，囊袋内植入张力环和人工晶状体。术后随访3～6个月，观察视力、人工晶状体位置及手术并发症。结果20只眼均顺利植入囊袋张力环和人工晶状体。术后1周最佳矫正视力0．3～0．5者8只眼（40％），0．6～0．8者10只眼（50％），1．0者2只眼（10％），与术前的光感～0．25比较有明显提高，经秩和检验差异有统计学意义（P=0．00）；术后1个月散瞳检查见20只眼人工晶状体均在囊袋内，位置居中，无偏移或瞳孔夹持；术后3个月，全组20只眼人工晶状体位正，视力稳定；随访期间无视网膜脱离、角膜内皮失代偿或玻璃体脱出等严重并发症发生。结论在行晶状体不全脱位的超声乳化手术中，应用虹膜拉钩干Ⅱ囊袋张力环可提高手术安全性，并可防止人工晶状体偏移及其他并发症。Objective To evaluate the clinical effect of iris retractor and capsular tension ring in phacoemulsifieation for the treatment of subluxation of lens. Methods Twenty eyes of 20 cases of traumatic cataract with subluxation of lens underwent phacoemulsification. After continuous curvilinear capsulorrhexis, the iris retractor was inserted from the limbal puncture site to drag and fixate the edge of capsulorhexis opening, and then phacoemulsification and aspiration were performed. Finally, capsular tension ring and intraocular lens were implanted into the capsular bag. The visual acuity, intraocular lens location and surgical complications were observed for 3-6 months. Results The capsular tension ring and intraocular lens were successfully implanted in all 20 eyes. At 1 week after the surgery, the best corrected visual acuity were 0.3-0.5 in 8 eyes （40%）, 0.6-0.8 in 10 eyes （50%）, and 1.0 in 2 eyes （ 10% ）. Postoperative visual acuity significantly improved compared with preoperative visual acuity （ light perception-0.25 ） by rank sum test （P=0. 00）. At 1 month after the surgery, the intraocular lens located safely and centrally in the capsular bag in all cases using mydriasis examination, with no deviation or pupillary capture. The visual acuity was stable and the intraocular lenses were all in the right position at 3 months. No severe complications such as retinal detachment, corneal endothelium decompensation or vitreous prolapse were observed dnring follow-up. Conclusion Application of iris retractor and capsular tension ring in phacoemulsifieation for lens subluxation can improve operation safety and prevent intraocular lens deviation and other complications.

关 键 词：晶状体不全脱位 超声乳化术 虹膜拉钩 囊袋张力环 

分 类 号：R779.66[医药卫生—眼科]