外伤性晶状体脱位改良睫状沟缝线固定人工晶状体植入术的效果  

The efficacy of modified ciliary sulcus suture fixation of intraocular lens for the treatment of traumatic luxation of lens

作　　者：鲁诚[1] 魏承丽[1] 禹建曦 岳绍梅 Lu Cheng;Wei Chengli;Yu Jianxi;Yue Shaomei(Department of Ophthalmology,the First People’s Hospital of Xinxiang,Xinxiang,Henan 453000,China)

机构地区：[1]新乡市第一人民医院眼科,河南新乡453000

出　　处：《中华眼外伤职业眼病杂志》2021年第12期881-887,共7页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的评价改良巩膜瓣下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效果。方法随机对照研究。新乡市第一人民医院2018年1月至2019年6月外伤性晶状体脱位60例(60只眼),按随机数字表法分为两组:传统组30例,行传统睫状沟缝线固定植入术;改良组30例,行改良睫状沟缝线固定人工晶状体植入术,术中行UBM检查。随访12个月,比较两组的有效率、视力、人工晶状体偏心量、倾斜度及影响疗效的因素。结果改良组手术总有效率为93.33%(28/30),高于传统组的70.00%(21/30)(χ^(2)=5.455,P=0.020)。手术后改良组的视力(BCVA,logMAR)为-0.12±0.01,优于传统组的0.01±0.003(t=68.201,P<0.001)。重复测量结果显示,术后1周、1、6及12个月改良组患者的平均偏心量及平均倾斜度均低于传统组(均P<0.05)。多因素Logistic回归分析显示,并发症发生、偏心量≥1 mm及倾斜度>5°为晶状体脱位患者影响疗效的因素。结论改良睫状沟缝线人工晶状体植入术治疗晶状体脱位效果较好且并发症较少。平均偏心量≥1 mm及平均倾斜度>5°为外伤性晶状体脱位疗效的影响因素。Objective To evaluate the efficacy of modified subscleral ciliary sulcus suture fixation of intraocular lens(IOL)for traumatic luxation of lens.Methods This was a rondom control study.A total of 60 eyes of 60 cases of traumatic luxation of lens from Jan.2018 to Jun.2019 in the First People’s Hospital of Xinxiang were divided into two groups based on the random number table method.Thirty eyes of 30 cases in the traditional group underwent traditional ciliary sulcus suture fixation of IOL during the implantation.Thirty eyes of 30 cases in the modified group underwent modified ciliary sulcus suture fixation of IOL during the implantation with intraoperative UBM examination.All cases were followed up for 12 months.The effective rate,visual acuity,IOL eccentricity,inclination and influencing factors between the two groups were compared.Results The total effective rate of the modified group was 93.33%(28/30),which was higher than the 70%(21/30)of the traditional group(χ^(2)=5.455,P=0.020).The postoperative visual acuity(BCVA,logMAR)of the modified group was-0.12±0.01,which was better than the 0.01±0.003 of the traditional group(t=68.201,P<0.001).Repeated measurements showed that the average eccentricity and average inclination of the modified group were lower than those of the traditional group at 1 week,1 month,6 months and 12 months postoperatively(all P<0.05).A multivariate Logistic regression analysis showed that the incidence of complications,eccentricity≥1 mm and inclination>5°were the factors affecting the efficacy of lens dislocation.Conclusion The efficacy of modified ciliary sulcus suture during IOL implantation is better and the incidence of complications is lower.The average eccentricity≥1 mm and average inclination>5°are the influencing factors of traumatic luxation of lens.

关 键 词：晶状体半脱位 晶状体 人工 晶状体植入 眼内 固定 缝线 睫状沟 改良 并发症 因素 影响 效果 

分 类 号：R779.6[医药卫生—眼科]