改良睫状沟缝线固定人工晶状体植入术治疗外伤性晶状体脱位的临床观察  

Intraocular Lens Implantation with Modified Ciliary Sulcus Suture Fixation for Traumatic Lens Dislocation

作　　者：罗艳[1] 程旭康[1] 杨慧[1] 金翼[1] 冯劼[1] Luo Yan;Cheng Xukang;Yang Hui(Department of Ophthalmology,Wuhan No.1 Hospital,Wuhan 430015,China)

机构地区：[1]武汉市第一医院眼科,武汉430015

出　　处：《华中科技大学学报（医学版）》2018年第5期615-619,共5页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

基　　金：武汉市卫生计生委科研基金资助项目(No.WX15B18;No.WX16C35)

摘　　要：目的评价超声生物显微镜(ultrasound biomicroscopy,UBM)辅助下的改良睫状沟缝线固定人工晶状体植入术治疗外伤性晶状体脱位的临床疗效。方法对2013年1月至2016年12月于武汉市第一医院行睫状沟缝线固定人工晶状体植入术的外伤性晶状体脱位病例43例(46眼)进行回顾性研究。其中2013年至2014年病例均采用传统巩膜瓣下睫状沟缝线固定术,设为对照组,共25例(28眼)。2015年起病例采用改良术式,设为实验组,18例(18眼)。术前行UBM检查,了解睫状沟位置结构,选择睫状沟固定位点。在固定位点旁制作口袋样板层巩膜隧道。行晶状体摘除及人工晶状体悬吊术,结扎缝线关闭巩膜隧道,同时将线结埋藏于隧道内。观察、记录术前和术后1周、1月、12月的裸眼视力(uncorrected visual acuity,UCVA),以及术中及术后并发症。通过Pentacam检查及Image Pro Plus软件分析人工晶状体的位置。结果实验组和对照组患者术后裸眼视力均有一定程度的提高,术中及术后未见明显并发症,线结埋藏切口闭合满意。术后第1天,实验组平均偏心量为(0.44±0.17)mm,小于对照组[(0.66±0.19)mm],差异有统计学意义(P<0.05)。两组平均偏心量在术后1周及1月有所下降,12月时偏心量增大,差异有统计学意义(P<0.05)。术后第1天,实验组平均倾斜度为(3.22±1.35)°,小于对照组(4.96±1.91)°,差异有统计学意义(P<0.05)。两组在随后的1周、1月、12月,平均倾斜度均有所下降。结论 UBM术前检查能够辅助选择合适的缝合位点从而提高术后视觉质量。改良的口袋样板层巩膜隧道埋线法,关闭切口及埋线同时完成,操作简便,并发症少。Objective To evaluate the clinical efficacy of intraocular lens implantation with ultrasound biomicroscopy(UBM)-assisted modified ciliary sulcus suture fixation in the treatment of traumatic lens dislocation.Methods Clinical data of 43 patients with traumatic lens dislocation(/16 cycs)who were treated in our hospital fromJanuary 2013 to December 2016 were retrospectively analyzed.Conventional ciliary sulcus suture fixation beneath a scleral flap(25 cases?28 eyes)was performed du--ing 2013 to 2014 in the control group.In the modified groups 18 paticnts(18 eyes)received the intraocular lens implantation with UBM-assisted modified ciliary sulcus suture fixation,which has been carried out since 2015 in our hospital Preoperative UBM examination was performed to locate the ciliary sulcus and select the sites of ciliary sulcus fixation.A pockct-like scleral tunnel in the lamina was made near the fixation sit..Lens extraction and intraocular lens suspension were performed.Ligature and suture were used to close the scleral tunnel and bury the thread knot in the tunnd.Uncorrcctcd visual acuity(UCVA)?intraoperative and postoperative complications were observed before and 1 week,1 month and 12 months after the operation.The location of intraocular lens was analyzed by Pcntacam examination and Image Pro Plus software.Results The naked eyesight of patients in both groups was improved to some extern.Inhere were no obvious complications during and after the operation.T'he burial incision of the knot was satisfactory.On the first day after opcration,he average eccentricity in the modified group was(0.Z-li 0.17.)mm,which was less than that in the control group(0.66土0.19)mm(P〈0.05).The average eccentricity decreased in the two groups after 1 week and 1 month,and the eccentricity increased after 12 month..On the first day after the operation,the av erage tilt in themodified group was(3.22土.35.)degrees,which was smaller than that in the control group(4.96土1.9 1.)degrees,and the difference was significant(P〈0.05).The

关 键 词：超声生物显微镜 人工晶状体 缝合固定 晶状体脱位 

分 类 号：R776[医药卫生—眼科]