球形晶状体白内障术后合并黄斑水肿一例  

Macular edema after cataract surgery in a patient with microspherophakia:a case report

作　　者：肖瑶瑶 蒋永祥 XIAO Yaoyao;JIANG Yongxiang(Mudanjiang Hospital of Heilongjiang Beidahuang group,Jixi 158300,China;Department of Ophthalmology,Eye and ENT Hospital of Fudan University、NHC Key Laboratory of Myopia(Fudan University)、Key Laboratory of Myopia,Chinese Academy of Medical Sciences、Key Laboratory of Visual Impairment and Restoration of Shanghai,Shanghai 200031,China)

机构地区：[1]黑龙江省北大荒集团牡丹江医院,黑龙江鸡西158300 [2]复旦大学附属眼耳鼻喉科医院眼科、国家卫生健康委员、会近视眼重点实验室、中国医学科学院近视眼重点实验室、上海市视觉损伤与修复重点实验室,上海200031

出　　处：《眼科学报》2023年第2期154-160,共7页Eye Science

基　　金：国家自然科学基金(82070943);上海市科学技术委员会科技创新行动计划(20Y11911000)。

摘　　要：球形晶状体是一种罕见的先天性晶状体悬韧带疾病,表现为晶状体前后径增加,赤道半径减小,类似球形。临床特点包括浅前房、晶状体源性高度近视、晶状体脱位及继发青光眼等。治疗上早期可以通过验光配镜提高视力,当继发晶状体脱位及青光眼时需尽早进行手术治疗。本例报道一例72岁男性患者,因右眼视力下降2年入院。既往近视,近视逐渐加深,近2年患者双眼配镜-10D,视力无明显改善。就诊后考虑球形晶状体所致晶状体不全脱位合并白内障,入院后行囊袋拉钩固定下白内障超声乳化+人工晶状体悬吊+前段玻璃体切割术。患者术后1个月后复诊,发现黄斑水肿,予以复方平地木颗粒口服,溴芬酸钠滴眼液滴眼。2周后复诊视力及黄斑水肿明显好转。Microspherophakia(MSP)is a rare congenital zonular dysplasia characterized by increased anteroposterior lens thickness and reduced equatorial diameter,resembling a spherical shape.The related ocular manifestations of MSP include shallow anterior chamber,lens derived high myopia,ectopia lentis and secondary glaucoma.In the early stage of MSP,vision acuity may be improved by glasses.Cataract surgery is necessary once secondary lens dislocation and glaucoma occur.A 72-year-old male hospitalized patient was reported who complained increased blurred vision of his right eye for 2 years.In the past 2 years,the power of his binocular glasses was increased to-10 diopters without significant improvement in visual acuity.Lens dislocation and phakic insufficiency caused by MSP was diagnosed after he attending clinics at the Eye and ENT Hospital of Fudan University,Shanghai,China.Phacoemulsification with scleral sutured intraocular lens(IOL)implantation surgery and anterior vitrectomy were performed.One month after operation,macular edema was found at first follow-up.Compound pingdingmu granule was taken orally and Bromfenac sodium eye drops were applied three times a day.Two weeks later,visual acuity of his right eye was improved significantly and macular edema was eliminated dramatically.

关 键 词：球形晶状体 黄斑水肿 晶状体不全脱位 晶状体悬韧带病变 前段玻璃体切割术 

分 类 号：R779.6[医药卫生—眼科]