复杂性眼外伤保留周边前囊的晶状体玻璃体切除人工晶状体植入术  

The lensovitrectomy with preservation of peripheral anterior capsule and intraocular lens implantation for complicated ocular trauma

作　　者：孙晓宇 李海岗 崔国义 姜海烽 Sun Xiaoyu;Li Haigang;Cui Guoyi;Jiang Haifeng(Zhoukou Aier Eye Hospital,Henan 466001,China)

机构地区：[1]周口爱尔眼科医院,河南466001

出　　处：《中华眼外伤职业眼病杂志》2020年第6期413-417,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的探讨保留周边部前囊的晶状体玻璃体切除人工晶状体植入术治疗复杂性眼外伤的临床意义。方法前瞻性病例对照研究。以周口爱尔眼科医院2017年3月至2019年7月收治的复杂性眼外伤合并玻璃体积血80例(80只眼)为对象。患者按照随机数字表法分为两组,各40例(40只眼)。观察组行保留周边前囊的晶状体玻璃体切除人工晶状体植入术,对照组行常规晶状体玻璃体切除人工晶状体悬吊术(未保留前囊)。术后随访6个月,观察比较两组疗效。结果术后1周观察组角膜内皮细胞密度高于对照组(t=7.852,P=0.000)。术后6个月,观察组视力优于对照组(t=8.944,P=0.000)。眼压低于对照组(t=42.683,P=0.008)。角膜高阶像差低于对照组(t=4.525,P=0.000)。观察组术后发生眼压增高、虹膜粘连及角膜水肿的例数均低于对照组(均P<0.05)。结论保留周边部前囊的晶状体玻璃体切除人工晶状体植入术治疗复杂性眼外伤,能减少角膜内皮细胞损伤,改善术后视力,降低眼压,且并发症少。Objective To investigate the clinical significance of lensovitrectomy with preservation of peripheral anterior capsule and intraocular lens implantation for complicated ocular trauma.Methods This was a prospective case-control study.A total of 80 eyes of 80 cases with complicated ocular trauma and vitreous hemorrhage from Mar.2017 to Jul.2019 in Zhoukou Aier Eye Hospital were divided into two groups randomly,with 40 eyes of 40 cases in each group.The observation group underwent lensovitrectomy with preservation of peripheral anterior capsular and intraocular lens implantation,while the control group underwent conventional lensovitrectomy and intraocular lens suspension(removal of peripheral anterior capsule).The patients were followed up for 6 months after operation.The operation efficacies were compared and observed.Results The corneal endothelial cell density in the observation group was higher than that in the control group at 1 week after operation(t=7.852,P=0.000).The visual acuity in the observation group was higher than that in the control group at 6 months after operation(t=8.944,P=0.000).The intraocular pressure in the observation group were lower than those in the control group(t=42.683,P=0.008),and the corneal higher order aberration in the observation group was lower than that in the control group(t=4.525,P=0.000).The incidence of postoperative increased intraocular pressure,iris adhesion and corneal edema in the observation group were lower than those in the control group(all P<0.05).Conclusion Lensovitrectomy with preservation of peripheral anterior capsule and intraocular lens implantation for complicated ocular trauma can effectively reduce injury of corneal endothelial cell,improve postoperative vision,reduce intraocular pressure,and has less complications.

关 键 词：玻璃体积血 晶状体前囊 眼损伤 晶状体玻璃体切除术 植入 晶状体 人工 

分 类 号：R779.6[医药卫生—眼科]