超声生物显微镜辅助折叠人工晶状体单襻悬吊术治疗残留部分囊膜无晶状体眼患者临床疗效分析  

Therapeutic effects of ultrasound biomicroscopy assisted intraocular lens suspension surgery with one loop suturing for residual lens capsule aphakia

作　　者：苏锐锋[1] 谭小波[1] 郭立涛[1] 董微丽[1] 

机构地区：[1]承德医学院附属医院眼科,河北省承德市067000

出　　处：《眼科新进展》2017年第2期175-178,共4页Recent Advances in Ophthalmology

摘　　要：目的评价超声生物显微镜(ultrasound biomicroscopy,UBM)辅助折叠人工晶状体单襻悬吊术治疗残留部分囊膜无晶状体眼患者的临床疗效。方法收集2012年10月至2015年1月于我院行二期人工晶状体植入术的患者50例(50眼),UBM检查显示晶状体囊膜残余大于等于180°。采用随机数字表法将患者分为2组,每组25例(25眼)。两组均行人工晶状体单襻悬吊术。试验组根据术前UBM结果选择进针缝合部位,对照组根据经验选择进针缝合部位。分别观察术前和术后1周、1个月、3个月的裸眼视力(uncorrected visual acuity,UCVA)和散光度,比较术后3个月UBM测量计算所得的人工晶状体偏心值和倾斜度,观察两组术后并发症情况。结果同术前相比较,两组患者术后各个时间点的UCVA均明显升高(均为P<0.05),且术后随着时间的延长,UCVA逐渐提高(均为P<0.05);两组间相比较,术前和术后1周的UCVA差异无统计学意义(P>0.05)。术后1个月、3个月试验组UCVA明显高于对照组(均为P<0.05)。两组间术前和术后1周散光度差异无统计学意义(均为P>0.05)。术后1个月、3个月试验组散光度明显低于对照组(均为P<0.05)。试验组人工晶状体确切植入睫状沟的比例明显高于对照组(P<0.01)。术后3个月时试验组偏心值为(0.36±0.17)mm、倾斜度(2.13±0.90)°;对照组偏心值为(0.69±0.17)mm、倾斜度(4.78±1.90)°。试验组人工晶状体的偏心值和倾斜度均明显小于对照组(均为P<0.01)。术后对照组中有3例出现前房或玻璃体少量积血;试验组有1例、对照组有2例术后早期出现眼压升高,给予降眼压药物,3个月后眼压均降至正常,停药后无复发。结论 UBM辅助折叠人工晶状体单襻悬吊术可以明显提高术后视觉质量且安全稳定,可以作为人工晶状体悬吊术的常规术前检查。UBM为人工晶状体偏心值和倾斜度的计算提供了一种可供选择的方法。Objective To evaluate the therapeutic effects of ultrasound biomicroscopy（UBM） assisted intraocular lens suspension surgery with one loop suturing for residual lens capsule aphakia.Methods Fifty aphakia patients（50 eyes） with residual lens capsular equal or greater than 180 degrees were chosen.The patients were randomly divided into 2 groups and underwent intraocular lens suspension surgery with one loop suturing：Trial group（25 cases,25eyes） selected suture site according to the preoperative UBM results,and control group（25 cases,25 eyes） selected the suture site according to the clinical experience.The uncorrected visual a—cuity（UCVA）,astigmatism at preoperative and postoperative 1 week,1 month and 3 months were observed,the eccentric and tilt value of the lens were calculated by UBM measurement at 3month after operation,and the postoperative complications of the two groups were observed.Results UCVA at each time point after operation were higher than that before operation,and gradually increased with time.There was no significant difference between the two groups at 1week before and after the operation of U C VA（P〉0.05）.At 1 month and 3 months after operation,U CVA in trial group were significantly higher than those of control group（all P〉0.05）.The astigmatism value at 1 week after operation in two groups was higher than that before operation and gradually decreased with time.The astigmatism value in trial group at 1 month and 3months after operation had no significant difference with that of preoperative（P〉0.05）,while the astigmatism value in control group increased（all P〉0.05）.The astigmatism values had no significant difference between the two groups before and 1 week after operation（all P〉0.05）,which were significantly lower in trial group at 1 month and 3 months after operation（all P〉0.05）.Three months after surgery,the proportion of lens accurately implanted in the ciliary sulcus was significantly higher than control group（P〉0.01）,the eccen

关 键 词：超声生物显微镜 人工晶状体 单襻悬吊术 缝合固定 

分 类 号：R776[医药卫生—眼科]