缝纫式复位、囊膜拉钩固定联合囊袋张力环植入超声乳化治疗外伤性虹膜根部离断合并晶状体半脱位的效果  

The effect of continuous sewing suture,capsular hook fixation combined with capsular tension ring implantation phacoemulsification in the treatment of traumatic iridodialysis complicated by lens subluxation

作　　者：金玲艳[1] 张令洁 段宏辉 伍海建[1] JING Lingyan;ZHANG Lingjie;DUAN Honghui;WU Haijian(Taizhou Eye Hospital,Ophthalmologic Center of Taizhou Municipal Hospital,Taizhou 318000,China)

机构地区：[1]台州市眼科医院、台州市立医院眼科中心,浙江台州318000

出　　处：《温州医科大学学报》2023年第5期412-415,419,共5页Journal of Wenzhou Medical University

摘　　要：目的:探讨连续缝纫式复位、囊膜拉钩固定联合囊袋张力环(CTR)植入超声乳化治疗外伤性虹膜根部离断合并晶状体半脱位的效果。方法:对2016年1月至2020年6月台州市眼科医院收治的19例(19眼)外伤性虹膜根部离断和晶状体半脱位伴外伤性白内障患者行内路连续缝纫式虹膜根部离断复位,联合临时性自制囊膜拉钩囊袋固定下的晶状体半脱位超声乳化及CTR和人工晶状体(IOL)植入。术后随访6个月,观察视力、眼压、虹膜根部复位、瞳孔形状和IOL位置情况。结果:19眼手术成功,术中无虹膜损伤及后囊膜破裂等并发症。术后所有术眼虹膜根部离断完全复位;瞳孔基本圆形15眼,近似圆形或竖椭圆形各2眼;IOL位置均良好。术后最佳矫正视力较术前明显提高,差异均有统计学意义(P<0.01);术后眼压正常,与术前相比差异无统计学意义(P>0.05)。结论:连续缝纫式复位、囊膜拉钩固定联合CTR植入超声乳化治疗外伤性虹膜根部离断和晶状体半脱位,手术损伤小,提高了超声乳化手术的安全性。术后虹膜离断根部复位,IOL位正,视力恢复理想。Objective:To study the curative effect of the continuous sewing suture,capsular hook fixation combined with capsular tension ring(CTR)implantation phacoemulsification in treatment of traumatic iridodialysis with lens subluxation.Methods:Altogether 19 patients(19 eyes)with traumatic iridodialysis and lens subluxated with traumatic cataract who underwent the continuous sewing suture to repair of iridodialysis combined phacoemulsification with temporary self-made capsular hook fixation as well as CTR and intraocular lens(IOL)implantation in Taizhou Eye Hospital from January 2016 to June 2020.Postoperative followed up for 6 months.Visual acuity,intraocular pressure(IOP),restoration of iridodialysis,pupillary shape and position of IOL were observed.Results:All eyes were operated successfully.No cases had iris damage or posterior capsular rupture.Complete postoperative restoration of iridodialysis was seen in all operated eyes.Among them 15 eyes were basically round pupils,with 2 eyes nearly round or oval pupil respectively.The IOLs in all operated eyes were at the central position.The best corrected visual acuity after surgery was significantly improved,compared with that before surgery,showing statistical difference(P<0.01).Postoperative intraocular pressure was normal,and there was no significant difference between preoperative and postoperative intraocular pressure(P>0.05).Conclusion:The continuous sewing suture,capsular hook fixation combined with CTR implantation phacoemulsification in the treatment of traumatic iridodialysis with lens subluxation can increase the safety of phacoemulsification with less surgical damage.Postoperative iridodialysis can be completely restored,IOL is centered and vision is ideally recovered.

关 键 词：虹膜根部离断 晶状体半脱位 缝纫式复位 超声乳化 

分 类 号：R779.6[医药卫生—眼科]