囊袋上经巩膜缝线固定IOL植入术治疗球形晶状体的有效性和安全性研究  

The efficacy and safety of the application of phacoemulsification combined with supra-capsular and scleral-fixated intraocular lens implantation in microspherophakia surgery

作　　者：陈泽旭 闻一诺 孙杨 贾婉楠 蒋永祥[1] CHEN Zexu;WEN Yinuo;SUN Yang;JIA Wannan;JIANG Yongxiang(Eye&ENT Hospital,Fudan University,Shanghai 200031;The First Clinical Medical College of Wenzhou Medical University,Wenzhou 325035)

机构地区：[1]复旦大学附属眼耳鼻喉科医院,上海200031 [2]温州医科大学第一临床医学院,温州325035

出　　处：《眼科学报》2023年第2期92-100,共9页Eye Science

基　　金：上海市科学技术委员会“科技创新行动计划”医学创新研究项目(20Y119110);上海市科学技术委员会“科技创新行动计划”医学创新研究项目(22Y11910400)。

摘　　要：目的:探讨超声乳化晶状体吸除联合囊袋上经巩膜缝线固定人工晶状体(intraocularlens,IOL)植入术治疗球形晶状体(microspherophakia,MSP)的有效性和安全性。方法:采用回顾性分析,选取2019年1月至2020年6月期间在复旦大学附属眼耳鼻喉科医院进行治疗的MSP患者37例(37眼),随机分为两组,纳入行超声乳化晶状体吸除联合囊袋上巩膜缝线固定IOL植入术(supra-capsular and scleral-fixated intraocular lens implantation,SCSF-IOL)的MSP患者20例(20眼)和行超声乳化晶状体吸除联合改良型囊袋张力环植入术(transscleral-fixated modified capsular tension ring and in-thebag intraocular lens implantation,MCTR-IOL)的MSP患者17例(17眼),观察两组术后最佳矫正视力及并发症等情况。结果:两组术后最佳矫正视力比术前均有改善(P<0.001),而组间比较差异无统计学意义(P=0.326)。两组的IOL倾斜度相当(P=0.216)。预防性Nd:YAG激光后囊膜切开术在SCSFIOL术后1周至1个月进行。在SCSF-IOL组,2眼(10.00%)需要重复激光治疗,1眼(5.00%)出现囊口偏心。后囊膜混浊是MCTR组最常见并发症(6眼,35.29%)。随访期间两组均未出现IOL脱位、继发性青光眼和视网膜脱离。结论:SCSF-IOL是治疗球形晶状体的简单易行的手术方式,疗效与MCTR-IOL相当。Nd:YAG激光后囊膜切开术是预防SCSF-IOL术后囊袋并发症的必要手段。Objective:To investigate the efficacy and safety of phacoemulsification combined with supra-capsular and scleral-fixated intraocular lens(IOL)implantation in the treatment of microspherophakia(MSP).Methods:by retrospective analysis,37 MSP patients(37 eyes)who were treated in our hospital from January 2019to June 2020 were randomly divided into two groups,including 20 MSP patients(20 eyes)who treated by SCSF-IOL and 17 MSP patients(17 eyes)who treated by transscleral-fixated modified capsular tension ring and in-the-bag intraocular lens implantation(MCTR-IOL).The best corrected vision and complications were observed.Results:the best corrected vision was significantly improved in both groups(P<0.001),but there was no remarkable difference between the two groups(P=0.326).The IOL tilt was also comparable(P=0.216).Prophylactic Nd:YAG laser posterior capsulotomy was performed from 1 week to 1 month after the SCSF-IOL procedure.In the SCSF-IOL group,two eyes(10.00%)needed repeated laser treatment,and one eye(5.00%)had a decentered capsule opening.Posterior capsular opacification was the most common complication(6,35.29%)in the MCTR group.No IOL dislocation,secondary glaucoma,or retinal detachment was observed during follow-up.Conclusion:SCSF-IOL is a simple and viable surgical option for managing MSP and is comparable with the MCTR-IOL.Nd:YAG laser posterior capsulotomy is a necessary mean to prevent residual capsule complications after the SCSF-IOL procedure.

关 键 词：球形晶状体 囊袋 超声乳化吸出术 改良囊袋张力环 

分 类 号：R779.6[医药卫生—眼科]