虹膜拉钩联合囊袋张力环在外伤性晶状体半脱位超声乳化手术中的应用效果  

Application of iris hook combined with capsular tension ring in phacoemulsification for traumatic lens subluxation

作　　者：聂玉红 张雨[1] 杨扬 邢怡桥[1] 陈震[1] Nie Yuyong;Zhang Yu;Yang Yang;Xing Yiqiao;Chen Zhen(Department of Ophthalmology,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院眼科中心,430060

出　　处：《临床眼科杂志》2021年第1期54-57,共4页Journal of Clinical Ophthalmology

摘　　要：目的观察虹膜拉钩联合囊袋张力环在外伤性晶状体半脱位超声乳化手术中的临床效果,探讨其有效性和安全性。方法回顾性分析2016年9月至2018年9月武汉大学人民医院眼科中心收治的56例(56只眼)外伤性晶状体半脱位患者,这些患者术前经裂隙灯检查和超声生物显微镜(UBM)检查确定晶状体半脱位,脱位范围≤180°。术中使用虹膜拉钩和囊袋张力环辅助完成超声乳化联合人工晶状体植入术。观察患者术后最佳矫正视力、眼压、人工晶状体位置、术中术后并发症的情况。结果术中无后囊膜破裂,4例患者术中发现晶状体脱位范围超过180°,有12例患者术中行前段玻璃体切除术,所有患者成功植入囊袋张力环和人工晶状体。术后随访12~36个月。术后随访期间,14例患者眼压一过性升高,使用药物治疗后恢复正常;最后一次随访时视力均有不同程度提高,2例人工晶状体轻度偏位,8例出现后发性白内障,无角膜内皮失代偿、视网膜脱离和脉络膜脱离发生。结论虹膜拉钩与囊袋张力环可作为外伤性晶状体半脱位患者超声乳化联合人工晶状体植入术的有效辅助手段。Objective To observe the efficacy and safety of iris hook combined with capsular tension ring in phacoemulsification for traumatic lens subluxation.Methods A total of 56 patients with traumatic lens subluxation admitted to the ophthalmic center of Renmin Hospital of Wuhan University from September 2016 to September 2018 were retrospectively analyzed.The degree of lens subluxation was confirmed by slit lamp and UBM before the surgery,and the dislocation range was less than or equal to 180°degrees.Phacoemulsification and intraocular lens(IOL)implantation were performed with iris hook and capsular tension ring.The postoperative best-corrected visual acuity(BCVA),intraocular pressure,intraocular lens position,intraoperative and postoperative complications were recorded.Results The follow-up time ranged from 12 months to 36 months.Posterior capsule rupture did not occur in any eyes and four patients had subluxated lens with zonular dialysis over 180 degrees during the operation.Twelve patients underwent anterior vitrectomy during operation.The capsular tension ring and intraocular lens were successfully implanted in all patients.During the follow-up period,14 patients developed a transient increase in intraocular pressure,and returned to normal after medical therapy.At the last follow-up,the BCVA significantly improved with different degrees and no complications were observed,such as high intraocular pressure,corneal endothelium decompensation,retinal detachment and choroidal detachment.Two cases had slightly decentrated intraocular lens and 8 cases had posterior capsular opacification.Conclusions Iris hook and capsular tension ring can be used as effective auxiliary instruments during phacoemulsification and IOL implantation in patients with traumatic lens subluxation.

关 键 词：虹膜拉钩 囊袋张力环 外伤性晶状体半脱位 白内障超声乳化术 

分 类 号：R68[医药卫生—骨科学]