外伤性晶状体不全脱位不同手术方式的临床效果  

The efficacy of various surgical procedures for the treatment of traumatic subluxation of lens

作　　者：郑广瑛[1] 马惠惠[1] 李莉[1] 

机构地区：[1]郑州大学第一附属医院,郑州450052

出　　处：《中华眼外伤职业眼病杂志》2016年第10期721-725,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的观察外伤性白内障合并晶状体不全脱位不同手术方式的临床效果。方法回顾性分析我院外伤性白内障合并晶状体不全脱位60例（60只眼）。依据晶状体脱位程度不同，分为四组，每组15例（15只眼）。A组，晶状体悬韧带断离范围〈90°，行超声乳化术联合大C襻三体式IOL囊袋内植入术；B组，晶状体悬韧带断离范围90°～〈180°，先植入囊袋张力环，再行超声乳化囊袋内植入IOL；C组，晶状体悬韧带断离范围180°～〈270°，先植入囊袋张力环，以聚丙烯线将其缝合固定在睫状沟内，再行超声乳化联合囊袋内植入IOL；D组，晶状体悬韧带断离范围≥270°，采用三通道闭合式晶状体切除联合前段玻璃体切除及IOL睫状沟缝线固定术。于术后1周，1、3、6个月随访，观察前房炎症反应，IOL位置，视力（BCVA）及并发症。结果术后1周，A组房水闪光（-），IOL居中，BCVA≥0．5者11只眼（73．3％）；B、C两组房水闪光（±），IOL居中，BCVA≥0．5者各9只眼（60．O％）；D组房水闪光（＋），IOL轻度偏心3只眼，BCVA≥0．5者4只眼（26．7％）。术后1个月，各组房水闪光（-），A组BCVA≥0．5者13只眼（86．7％）；B、C两组BCVA≥0．5者各12只眼（80．0％）；D组BCVA≥0．5者8只眼（53．3％）。术后3个月及6个月四个组IOL位置居中，视力稳定，无黄斑水肿、睫状体脱离或脉络膜脱离等并发症。结论根据晶状体不全脱位的程度不同而选用不同的手术方式，可显著提高术后视力，减少术中和术后并发症。Objective To observe the efficacy of various surgical procedures for the treatment of traumatic subluxation of lens. Methods Sixty eyes of 60 cases with traumatic cataract combined with subluxation of lens were retrospectively analysed. Based on the different degree of the dislocation of the lens, the patients were divided into four groups, each group contained 15 eyes of 15 cases. Group A, the range of broken suspensory ligament was 〈 90°, underwent phacoemulsification and implantation of the C loop IOL. Group B, the range was 90° - 〈 180°, underwent phacoemulsification combined with implantation of IOL and capsular tension ring. Group C, the range was 180° - 〈 270°, underwent capsular tension ring suture in the ciliary sulcus. Group D, the range was ≥ 270°, received the three channels closed lens ectomy and anterior segment vilmectomy and IOL implantation with the ciliary suture fixation. At 1 week, 1, 3 and 6 months after operation the anterior chamber inflammation, location of IOL, the best corrected visual acuity （ BCVA）, intraocular pressure and other complications were observed. Results One week after operation, in Group A, aqueous flare was （-） , position of IOL was centered. BCVA ≥0.5 were in 11 eyes（73.3% ） ; in Group B and Group C, aqueous flare was （ ＋ ）, position of IOL was centered, BCVA i〉 0.5 were in 9 eyes（60.0% ）. In Group D,aqueous flare was （ ＋ ）, IOL was slightly offset position in 3 eyes, BCVA ≥ 0.5 were in 4 eyes （ 26.7% ）. One month after operation, four groups of patients with anterior chamber inflammation reaction had subsided. In Group A, BCVA ≥0.5 were in 13 eyes （86.7%） ; in Group B and Group C, BCVA 30.5 were in 12 eyes （80.0%） in each group; in Group D, BCVA 〉10.5 were in 8 eyes （53.3%）. After 3 and 6 months after surgery, four groups of BCVA were stable, position of IOL centered and macular edema, detachment of cyclodialysis and choroidal detachment serious complication. Conclusion According to the degree of lens

关 键 词：眼外伤 晶状体不全脱位 外伤性 囊袋张力环 手术方式 效果 

分 类 号：R779.6[医药卫生—眼科]