后房型人工晶状体脱位眼内四点悬吊固定的临床疗效  

Clinical outcomes of four-point fixation for posterior chamber intraocular lens dislocation

作　　者：孙新成 卢国华 贾砚文 潘婷 黄丽琴 谢阳 Sun Xincheng;Lu Guohua;Jia Yanwen;Pan Ting;Huang Liqin;Xie Yang(Department of Ophthalmology,Changzhou No.2 People's Hospital Affiliated to Nanjing Medical University,Changzhou 213003,China)

机构地区：[1]南京医科大学附属常州第二人民医院眼科,江苏省常州市213003

出　　处：《中华实验眼科杂志》2021年第4期332-336,共5页Chinese Journal Of Experimental Ophthalmology

摘　　要：目的观察后房型人工晶状体脱位患者行四点缝线悬吊固定的临床效果。方法采用回顾性病例系列研究,收集2015年1月至2018年1月于常州市第二人民医院行脱位人工晶状体眼内四点缝线悬吊固定手术的后房型人工晶状体脱位患者16例16眼,术后随访6~13个月,分别测量并比较患者术前和术后6个月的裸眼视力(UCVA)、最佳矫正视力(BCVA)、角膜内皮细胞计数、散光值,分析总散光值与角膜散光值及人工晶状体源性散光值的关系,观察术后人工晶状体位置和并发症发生情况。结果术前术眼UCVA(LogMAR)和BCVA(LogMAR)分别为1.09±0.24和0.48±0.20,术后6个月分别提高至0.30±0.12和0.26±0.13,手术前后UCVA和BCVA比较差异均有统计学意义(t=11.782、3.795,均P<0.01)。术前和术后6个月术眼角膜内皮细胞计数分别为(2 270±360)/mm^(2)和(2 032±327)/mm^(2),手术前后比较差异无统计学意义(t=1.921,P=0.074)。术后6个月,术眼总散光值为(-1.47±0.82)D,角膜散光值为(-1.34±0.61)D,人工晶状体源性散光值为(-0.22±0.35)D;总散光值与角膜散光值呈显著正相关(r=0.885,P<0.05),总散光值与人工晶状体源性散光值无明显相关性(r=-0.432,P=0.095)。随访期间人工晶状体未见脱位、偏移、扭转等现象,术后早期术眼有不同程度的虹膜睫状体炎症状,对症治疗后均好转,2眼高眼压对症处理后眼压恢复正常,术中及术后未发生视网膜脱离、脉络膜脱离、爆发性脉络膜上腔出血、眼内炎和角膜内皮失代偿等并发症。结论对脱位人工晶状体行四点缝线悬吊固定术后人工晶状体位置稳定,患者视力恢复好,并发症少,是治疗人工晶状体脱位的有效方法。Objective To observe the clinical effect of four-point fixation in patients with posterior chamber intraocular lens dislocation.Methods A retrospective case series study was adopted.Sixteen patients(16 eyes)with posterior chamber intraocular lens dislocation who underwent suture suspension techniques with four-point fixation in Changzhou No.2 people's Hospital from January 2015 to January 2018 were enrolled.Postoperative effects were observed during follow-up,ranging from 6 to 13 months.The preoperative and 6-month postoperative uncorrected visual acuity(UCVA),best corrected visual acuity(BCVA),corneal endothelium cell count and astigmatism were measured and the differences were compared,and the relationships between total astigmatism and corneal astigmatism or intraocular lens induced astigmatism were analyzed,and the postoperative position of intraocular lens and complications were observed.This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of Changzhou No.2 People's Hospital(No.2015-C-012-01).Written informed consent was obtained from each patient before surgery.Results The mean preoperative UCVA(LogMAR)and BCVA(LogMAR)were 1.09±0.24 and 0.48±0.20,respectively,which were significantly improved to 0.30±0.12 and 0.26±0.13 at 6 months after operation,respectively.And the differences were statistically significant(t=11.782,3.795;both at P<0.01).The preoperative and 6-month postoperative corneal endothelium cell count were(2270±360)/mm^(2) and(2032±327)/mm^(2),respectively,and the difference was not significant(t=1.921,P=0.074).The 6-month postoperative mean total astigmatism,corneal astigmatism and intraocular lens induced astigmatism were(-1.47±0.82)D,(-1.34±0.61)D and(-0.22±0.35)D,respectively.There was a highly positive correlation between total astigmatism and corneal astigmatism(r=0.885,P<0.05),but there was no significant correlation between total astigmatism and intraocular lens induced astigmatism(r=-0.432,P=0.095).No dislocation,deviation or t

关 键 词：白内障 人工晶状体/脱位 手术 疗效 悬吊固定术 四点固定 

分 类 号：R779.6[医药卫生—眼科]