无巩膜瓣锯齿状缝线技术固定人工晶状体脱位  

The Zigzag Suture Technique for Re-Centering a Dislocated IOL without Using a Scleral Flap

作　　者：陈金桃[1] 张令洁 段宏辉 徐志伟[1] 伍海建[1] Jintao Chen;Lingjie Zhang;Honghui Duan;Zhiwei Xu;Haijian Wu(Taizhou Eye Hospital,Ophthalmological Center of Taizhou Municipal Hospital,Taizhou 318000,China)

机构地区：[1]台州市眼科医院台州市立医院眼科中心,318000

出　　处：《中华眼视光学与视觉科学杂志》2021年第12期918-924,共7页Chinese Journal Of Optometry Ophthalmology And Visual Science

摘　　要：目的:探讨无巩膜瓣无线结的巩膜层间锯齿状缝线技术(ZST)固定脱位人工晶状体(IOL)的临床疗效。方法:回顾性病例研究。选择2011年6月至2016年12月在台州市眼科医院收治的采用无巩膜瓣无线结的巩膜层间ZST重新复位固定的IOL脱位者21例(21眼),其中不全脱位者15眼,全脱位者6眼。术后2周、1个月、3个月及6个月定期随访。之后每12个月随访1次,共4~8次。观察分析患者术后的IOL位置和稳定性、术后视力、眼压及并发症情况。结果:术后所有术眼IOL位置良好,无偏位或IOL瞳孔夹持者,视力均较术前明显改善,眼压正常。随访期间,所有术眼IOL均在位居中,无偏位和倾斜现象;未见IOL巩膜ZST固定处聚丙烯线头侵蚀暴露,无聚丙烯线滑脱及局部结膜充血或眼内感染者;视力稳定良好,无高眼压或继发青光眼者。结论:无巩膜瓣无线结的巩膜层间ZST固定脱位IOL效果良好,术后IOL固定牢固,无线结侵蚀暴露及眼内感染风险。Objective:To study the surgical procedure and its clinical effects for an intrascleral zigzag suture technique(ZST)without using a scleral flap or knot to re-center a dislocated intraocular lens(IOL).Methods:This was a retrospective study.Twenty-one patients(21 eyes)with IOL dislocation underwent intrascleral ZST without using a scleral flap or knot to re-center dislocated IOLs at Taizhou Eye Hospital between June 2011 and December 2016.Among them,there were 15 eyes with subluxation of IOLs and 6 eyes with completely dislocated IOLs.Patients were regularly followed up at 2 weeks,1 month,3 months and 6 months and then every 12 months after that for a total of 4-8 times.The position of the IOL and its stability,visual acuity,intraocular pressure(IOP)and complications were observed and analyzed postoperatively.Results:Postoperative position of the IOL was in the center,unbiased position with no pupil capture.Visual acuity improved significantly compared to preoperative acuity and IOPs were normal in all operated eyes.During the follow-up period,the position of the IOL was in the center and unbiased position with no tilt.No erosion from exposure of the polypropylene thread end was observed at the scleral ZST fixation point of the IOL.There was no polypropylene suture slippage and no local conjunctive congestion or intraocular infection in any operated eye.Vision was stable and good.There was no high IOP or secondary glaucoma among the patients.Conclusions:Re-centering a dislocated IOL with intrascleral ZST produces good results.The IOL is re-centered firmly after the operation without using a scleral flap or knot.There is no risk of knot erosion from exposure or intraocular infection.

关 键 词：人工晶状体 脱位 无巩膜瓣 无线结 锯齿状缝合技术 

分 类 号：R779.66[医药卫生—眼科]