一种改良的简便的儿童晶状体不全脱位摘除技术  

A modified-simple technique of subluxated lens extraction in children

作　　者：蒙昫昀 秦华莉 韦恒光 李霞[1] MENG Xuyun;QIN Huali;WEI Hengguang;LI Xia(The First Affiliated Hospital of Guangxi Medical University,Nanning,China.2.State Key Laboratory of Ophthalmology,Zhongshan Ophthalmic Center,Sun Yat-sen University,Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science,Guangdong Provincial Clinical Research Center for Ocular Diseases,Guangzhou 510060,China)

机构地区：[1]广西医科大学第一附属医院,南宁530000 [2]中山大学中山眼科中心,眼科学国家重点实验室,广东省眼科视觉科学重点实验室,广东省眼部疾病临床医学研究中心,广州510060

出　　处：《眼科学报》2023年第2期127-131,共5页Eye Science

基　　金：国家自然科学基金委员会项目(81360144);广西自然科学基金委员会项目(2017GXNSFAA198250);广西壮族自治区卫生健康委员会项目(G201903029)。

摘　　要：目的:探讨一种改良的简便的儿童晶状体不全脱位摘除技术的手术方法及临床效果。方法:对23例(41眼)晶状体不全脱位儿童采用改良手术方法进行脱位晶状体摘除,术中先做巩膜隧道切口,3个角膜缘穿刺口,经穿刺口放置前房维持器,在维持前房灌注下,截囊针撕囊,水分离后抽吸针头吸净晶状体内容物。撤去前房维持器,用撕囊镊和线镊将囊袋从主切口拖出。若有玻璃体脱出则行前部玻璃体切割术,然后行人工晶状体巩膜缝线固定术。术后中位随访39.0个月,观察其手术效果。结果:术后患儿平均裸眼视力为(0.44±0.22)Log MAR,平均最佳矫正视力为(0.20±0.16)Log M AR,较术前均显著提高(P<0.001)。所有患儿术中眼内压稳定,术中术后没有继发视网膜脱离、脉络膜上腔出血等眼底并发症的发生。结论:改良的儿童晶状体不全脱位摘除技术具有对玻璃体扰动少、手术时间较短、简便易学、对手术设备要求低的优点,值得临床推广。Objective:To investigate the operation method and clinical effects of a modified-simple technique in children with subluxated lens extraction.Methods:Lens extraction was performed in 41 eyes of 23children.During operation,the scleral tunnel and 3 lateral corneal incision were made,and anterior chamber maintainer was inserted through one corneal incision.Under stable anterior chamber perfusion,anterior capsulorrhexis was made by needle capsulotome.After hydro-dissection,the content of lens was withdrawn by suction needle completely.Then anterior chamber maintainer was removed,and the capsular bag was dragged out by capsulorhexis forceps and fixation forceps.Anterior vitrectomy was performed if there was prolapse of vitreous.Then scleral intraocular lens fixation was performed.The surgical effects were observed at median 39.0 months postoperative.Results:After surgery,the average uncorrected visual acuity was(0.44±0.22)LogMAR,the average best corrected distant visual acuity was(0.2010.16)LogMAR.The uncorrected visual acuity and best corrected distant visual acuity were improved postoperative(P<0.001).The intraocular pressure of all patients was stable during operation.During and after operation,there were no fundus complications,such as secondary retinal detachment and suprachoroidal hemorrhage.Conclusion:Modified-simple technique of subluxated lens extraction of children has little disturbance on vitreous and takes shorter time of operation.It is simple,easy to learn and requires simple surgical equipment.This modified technique deserves to be generalized.

关 键 词：晶状体不全脱位 晶状体摘除术 儿童 

分 类 号：R779.6[医药卫生—眼科]