小切口可折叠四襻巩膜固定型人工晶状体植入术治疗马凡综合征晶状体半脱位  

Clinical results of four-point scleral-sutured foldable intraocular lens implantation via a small incision for patients with Marfan’s syndrome and ectopialentis

作　　者：王振茂[1] 肖凯霖 张少斌[1] 王耿[1] WANG Zhen-Mao;XIAO Kai-Lin;ZHANG Shao-Bin;WANG Geng(From the Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong,Shantou 515041,Guangdong Province,China)

机构地区：[1]汕头大学.香港中文大学联合汕头国际眼科中心,广东省汕头市515041

出　　处：《眼科新进展》2019年第5期440-443,共4页Recent Advances in Ophthalmology

基　　金：国家自然科学基金资助(编号:81270979;812007-19);广东省医学科学技术研究基金项目(编号:A2018478)~~

摘　　要：目的评价小切口可折叠四襻巩膜固定型人工晶状体(intraocular lens,IOL)植入术治疗马凡综合征晶状体半脱位患者的临床效果及安全性。方法回顾性病例分析。12例(21眼)马凡综合征伴透明晶状体半脱位患者行晶状体摘出联合IOL巩膜固定植入联合前段玻璃体切割术。其中,IOL巩膜固定采用了小切口(2.85 mm)、可折叠、一片式、四襻固定型美国博士伦Akreos IOL。观察患者术前、术后的裸眼视力(uncorrected visual acuity,UCVA)、最佳矫正视力(best corrected visual acuity,BCVA)、眼压、术中及术后并发症。结果所有患者手术均顺利,术中、术后未见并发症。术后第1天2眼出现一过性眼压升高。术前UCVA为0.01～0.30 (0.13±0.11),BCVA为0.01～0.60 (0.29±0.17)。随访33～73(57.75±13.78)个月,术后最后一次随访,UCVA为0.10～0.80(0.41±0.22),BCVA为0.20～1.00(0.70±0.27),两者与术前相比,差异均有统计学意义(均为P<0.05)。IOL位置居中,瞳孔圆。结论小切口可折叠四襻固定型Akreos IOL悬吊术治疗马凡综合征晶状体半脱位有良好的临床效果及安全性。Objective To evaluate the clinical results and safety of four-point scleral-sutured foldable intraocular lens (IOL) implantation through a small incision in the treatment of ectopialentis in patients with Marfan’s syndrome. Methods All patients were analyzed retrospectively.Twenty-one eyes of 12 Marfan’s syndrome patients with clear lens subluxation underwent lens aspiration combined with IOL scleral-fixation and anterior vitrectomy.A one-piece foldable Akreos IOL (Bausch & Lomb,USA) with 4 hollow haptics was sutured to the sclera through a 2.85 mm small incision.Uncorrected visual acuity(UCVA),best corrected visual acuity (BCVA),intraocular pressure,intraoperative and postoperative complications were evaluated. Results All eyes were successfully treated without intraoperative or postoperative complications.Transient ocular hypertension was observed in 2 eyes on the first postoperative day.Preoperative UCVA was 0.01-0.30(0.13±0.11) and BCVA was 0.01-0.60 (0.29±0.17).The mean follow-up period was 33-73 (57.75 ±13.78) months.At the last follow-up,the postoperative UCVA was 0.10-0.80(0.41±0.22) and the BCVA was 0.20-1.00 ( 0.70± 0.27),and UCVA and BCVA were improved significantly postoperatively (both P <0.05).Postoperative evaluation showed a well-centered IOL and round pupil in all patients. Conclusion Scleral fixation of a foldable Akreos IOL with 4 hollow haptics through a small incision is safe and effective in the treatment of ectopialentis in Marfan’s syndrome patients.

关 键 词：马凡综合征 晶状体半脱位 小切口 可折叠四襻巩膜固定型人工晶状体 临床效果 

分 类 号：R776[医药卫生—眼科]