改良折叠式人工晶状体悬吊术治疗外伤性晶状体脱位  

Efficacy of modified folding intraocular lens suspension surgery in treatment of traumatic dislocation of lens

作　　者：胡亚光 乔茜 刘轩[1] 雷剑琴[1] 谢安明[1] 李晶明[1] 张万虎 Ya-Guang Hu;Xi Qiao;Xuan Liu;Jian-Qin Lei;An-Ming Xie;Jing-Ming Li;Wan-Hu Zhang(Department of Ophthalmology,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,Shaanxi Province,China)

机构地区：[1]西安交通大学第一附属医院眼科,中国陕西省西安市710061

出　　处：《国际眼科杂志》2022年第7期1069-1073,共5页International Eye Science

基　　金：陕西省重点研发计划一般项目(No.2021SF-155);陕西省自然科学基金项目(No.2020JM-400)。

摘　　要：目的:评价改良折叠式人工晶状体(IOL)悬吊治疗外伤性晶状体脱位的手术技术。方法:前瞻性随机对照研究。共15例患者接受了改良折叠式IOL悬吊手术。其中,9例患者选择了Akreos AO IOL,使用聚丙烯缝线穿过IOL的环状襻,经巩膜引导穿刺后,缝合线末端热膨胀固定在巩膜。6例患者选择了Tecnis ZA9003 IOL,未使用缝合线,巩膜穿刺引导IOL襻穿出巩膜后,直接将IOL襻末端热膨胀固定在巩膜内。观察所有患者的最佳矫正视力(BCVA,LogMAR)及术后并发症。结果:研究共纳入15例患者,其中男7例,女8例,平均年龄64.00±9.85岁,平均病程5.80±3.17wk。人口统计学和基线临床特征之间没有显著差异。接受改良折叠式IOL悬吊手术后,所有患者视力均有明显改善。术后3mo,患者的BCVA(LogMAR)从1.28±0.56改善至0.52±0.30。其中,选择Akreos AO IOL患者的BCVA(LogMAR)从1.39±0.62改善至0.59±0.25,选择Tecnis ZA9003 IOL患者的BCVA(LogMAR)从1.12±0.45改善至0.42±0.35。此外,在我们的研究中没有观察到严重的术后并发症。仅1例患者IOL脱位,IOL光学面轻度倾斜。结论:改良折叠式IOL悬吊手术具有良好的视觉效果和预后,无严重并发症,是IOL悬吊手术的有效选择。AIM:To evaluate the efficacy of modified folding intraocular lens(IOL)suspension surgery in treatment of traumatic dislocation of lens surgery technique.METHODS:Prospective randomized controlled study.A total of 15 patients underwent the modified folding IOL suspension surgery.Among them,9 patients chose Akreos AO IOL,and polypropylene sutures were used to thread the haptics of IOL.After guided to puncture out through the sclera,the ends of sutures were thermal expanded and fixed in the sclera.And 6 patients chose Tecnis ZA9003 IOL and no sutures were used.After guided the haptics to puncture out through the sclera,the ends of haptics were thermal expanded and fixed in the sclera.The best corrected visual acuity(BCVA,LogMAR)of all patients and postoperative complication were observed.RESULTS:This study included 15 patients,among them,7 were male and 8 were female,the mean age was 64.00±9.85 years old,the mean course of diseases was 5.80±3.17 wk.There were no significant differences between the demographic and baseline clinical characteristics.After underwent the modified folding IOL suspension surgery,visual acuity of all patients were obviously improved.After 3mo of the surgery,the BCVA(LogMAR)of patients were improved from 1.28±0.56 to 0.52±0.30.More specifically,the BCVA(LogMAR)of patients who chose Akreos AO IOL were improved from 1.39±0.62 to 0.59±0.25,and those who chose Tecnis ZA9003 IOL of the BCVA(LogMAR)were improved from 1.12±0.45 to 0.42±0.35.Furthermore,there was no severe postoperative complication observed in our study.Only one patient suffered IOL dislocation and the IOL optical surface was mild oblique.CONCLUSION:Modified folding IOL suspension surgery technique resulted in good visual and outcomes with no severe complication,making it an effective option for IOL suspension surgery.

关 键 词：人工晶状体悬吊术 晶状体脱位 巩膜固定术 

分 类 号：R47[医药卫生—护理学]