白内障合并晶状体悬韧带异常的短期治疗效果观察  

Observation on the short-term surgical efficacy of cataract with zonulopathy

作　　者：剡晓川[1] 谷军峰 赵长霖 Yan Xiaochuan;Gu Junfeng;Zhao Changlin(Department of Ophthalmology,the 944th Hospital of Lianqin Support Force Chinese People’s Liberation Army,Jiuquan 735000,China;Department of Ophthalmology,General Hospital of Eastern Theater Command of the Chinese People’s Liberation Army,Nanjing 210000,China)

机构地区：[1]中国人民解放军联勤保障部队第九四四医院眼科,酒泉735000 [2]中国人民解放军东部战区总医院眼科,南京210000

出　　处：《中华眼外伤职业眼病杂志》2023年第3期218-223,共6页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的观察白内障合并不同程度晶状体悬韧带异常手术治疗的短期临床效果。方法回顾性病例系列研究。中国人民解放军联勤保障部队第九四四医院2018年12月至2022年6月手术治疗的晶状体悬韧带异常白内障患者37例(39眼),根据晶状体悬韧带异常范围将其分为3组:A组11例(11眼)悬韧带松驰或断裂范围<60°,行超声乳化白内障吸出及人工晶状体植入术;B组22例(23眼)悬韧带断裂范围60°~150°,行超声乳化联合囊袋内张力环和人工晶状体植入术;C组4例(5眼)悬韧带断裂范围>150°,行超声乳化联合前段玻璃体切除及人工晶状体睫状沟缝线固定术。术后随访3个月,检测患者手术前后最佳矫正视力、眼压、中央前房深度和角膜内皮细胞计数,观察手术并发症。结果A、B、C组术后各时间点最佳矫正视力均较术前提高,差异有统计学意义(F_(A)=17.00、F_(B)=28.58、F_(C)=9.73,均P<0.05),但各组患者术后1个月和术后3个月视力差异无统计学意义(均P>0.05)。术后1 d共有10例(10眼)眼压>21 mmHg,经1~3种降眼压药物治疗1~2周眼压均控制到正常范围。术后3个月,3组患者眼压均正常且无药物辅助。中央前房深度A组、B组术后3个月分别为(3.92±0.32)mm、(3.46±0.28)mm,较术前(2.91±0.42)mm、(2.77±0.38)mm明显加深(t_(A)=-9.06、t_(B)=-7.89,均P<0.05);C组术前为(2.85±0.85)mm,术后3个月为(3.20±0.09)mm,手术前后比较差异无统计学意义(P>0.05)。三组患者术后3个月角膜内皮细胞计数均较术前减少(t_(A)=13.55、t_(B)=35.59、t_(C)=13.95,均P<0.05)。结论白内障合并晶状体悬韧带异常患者,需根据晶状体悬韧带异常范围选择个体化手术方式治疗,可有效预防并发症发生,获得良好的视力。Objective To observe the short-term clinical efficacy of surgical treatment for cataract with varying degrees of zonulopathy.Methods This was a retrospective case series study.A total of 39 eyes of 37 cases with zonulopathy in the 944 Hospital of Lianqin Support Force of the Chinese People’s Liberation Army from Dec.2018 to Jun.2022 were included in this study.According to the rupture range or relaxation degree of suspensory ligament,the cases were divided into three groups:11 eyes of 11 patients with loose or ruptured suspensory ligament within 60°in group A underwent phacoemulsification combined with intraocular lens implantation;23 eyes of 22 patients in group B with suspensory ligament ruptured from 60°to 150°underwent phacoemulsification combined with intracapsular tension ring and intraocular lens implantation;5 eyes of 4 cases in group C with the rupture range of suspensory ligament above 150°underwent phacoemulsification combined with anterior vitrectomy and intraocular lens suture fixation on ciliary sulcus.The postoperative follow-up time was 3 months,the best corrected visual acuity(BCVA,LogMAR),intraocular pressure(IOP),central anterior chamber depth and density of corneal endothelial cell were detected before and after surgery.The surgical complications were documented.Results The postoperative visual acuity of group A,B,C was significantly improved respectively compared with that before surgery(F_(A)=17.00,F_(B)=28.58,F_(C)=9.73;all P<0.05).However,there was no statistically significant difference in BCVA between 1 month after surgery and 3 months after surgery in the three groups(all P>0.05).At 1 day after surgery,10 eyes of 10 cases with IOP>21mmHg were treated with 1-3 kinds of antihypertensive drugs for 1-2 weeks.Three months after surgery,all patients had normal IOP without any drug assistance.At 3 months after surgery,the depth of central anterior chamber in group A(3.92±0.32)mm and group B(3.46±0.28)mm was significantly deeper than that before surgery which was(2.91±0.42)mm and(2.77�

关 键 词：白内障 晶状体悬韧带 异常 短期治疗 

分 类 号：R776[医药卫生—眼科]