新型无线结Z缝合人工晶状体巩膜固定术对中重度囊袋/悬韧带支持不足患者眼压、视功能和屈光状态的影响  

Effects of new knotless Z-suture for scleral fixation of intraocular lens on intraocular pressure,visual function and refraction status in patients with moderate to severe inadequate capsule/suspensorium support

作　　者：李梅[1] 钟文金[1] 周升飞 LI Mei;ZHONG Wen-jin;ZHOU Sheng-fei(Department of Ophthalmology,Yan'an People's Hospital,Yan'an 716000,Shaanxi,CHINA;Department of Ophthalmology,Jingbian County Hospital of Traditional Chinese Medicine,Yulin 718500,Shaanxi,CHINA)

机构地区：[1]延安市人民医院眼科,陕西延安716000 [2]靖边县中医医院眼科,陕西榆林718500

出　　处：《海南医学》2023年第13期1898-1902,共5页Hainan Medical Journal

基　　金：陕西省延安市科技计划项目(编号:2021YF-22)。

摘　　要：目的探讨新型无线结Z缝合人工晶状体(IOL)巩膜固定术对中重度囊袋/悬韧带支持不足患者眼压、视功能和屈光状态的影响。方法回顾性分析2019年5月至2021年10月于延安市人民医院眼科治疗的108例中重度囊袋/悬韧带支持不足患者的临床资料,根据治疗方法不同分为无线结Z组50例和常规组58例,无线结Z组采用新型无线结Z缝合人工晶状体巩膜固定术,常规组采用常规硬性人工晶状体巩膜缝线固定术,比较两组患者治疗前后的眼压(IOP)、视功能、屈光状态、人工晶状体位置和手术并发症发生情况。结果术后,无线结Z组患者的峰值眼压、平均眼压和眼压波动值分别为(14.05±2.01)mmHg、(15.27±2.63)mmHg和(4.11±3.12)mmHg,明显低于常规组的(15.53±2.84)mmHg、(16.52±3.01)mmHg和(5.32±3.07)mmHg,差异均有统计学意义(P<0.05);术后,无线结Z组患者的最佳矫正视力(BCVA)、裸眼视力(UCVA)值分别为(0.11±0.07)logMAR、(0.21±0.26)logMAR,略低于常规组的(0.13±0.05)logMAR、(0.23±0.31)logMAR,但差异均无统计学意义(P>0.05),而无线结Z组患者的视功能生存质量量表(VF-QOL)水平为(85.12±16.07)分,明显高于常规组的(74.98±16.32)分,差异有统计学意义(P<0.05);术后,无线结Z组患者的屈光度、球镜度、柱镜度值分别为(0.47±0.19)D、(0.13±0.21)D、(-0.34±0.85)D,明显低于常规组的(0.61±0.32)D、(0.27±0.28)D、(-0.08±0.33)D,差异均有统计学意义(P>0.05);术后,无线结Z组患者的人工晶状体垂直偏心值(1.12±0.44)mm,明显小于常规组的(1.27±0.26)mm,差异有统计学意义(P<0.05),而两组患者的水平倾斜度、水平偏心值和垂直倾斜度比较差异均无统计学意义(P>0.05);无线结Z组患者的手术并发症总发生率为10.00%,明显低于常规组的29.31%,差异有统计学意义(P<0.05)。结论无线结Z缝合技术可用于晶状体囊袋/悬韧带支撑力中重度不足患者的人工晶状体巩膜固定术,在保证较好疗�Objective To explore the effects of new knotless Z-suture for scleral fixation of intraocular lens(IOL)on intraocular pressure(IOP),visual function,and refraction status in patients with moderate to severe inadequate capsule/suspensorium support.Methods The clinical data of 108 patients with moderate to severe inadequate capsule/suspensorium support treated in Department of Ophthalmology,Yan'an People's Hospital between May 2019 and Octo-ber 2021 were retrospectively analyzed.According to different treatment methods,they were divided into knotless Z-su-ture group(50 cases,new knotless Z-suture for IOL scleral fixation)and routine group(58 cases,routine rigid suture for IOL scleral fixation).IOP,visual function,refraction status,IOL sites,and occurrence of surgical complications were compared between the two groups before and after treatment.Results After surgery,peak IOP,mean IOP,and IOP fluc-tuation in the knotless Z-suture group were(14.05±2.01)mmHg,(15.27±2.63)mmHg,and(4.11±3.12)mmHg,which were significantly lower than(15.53±2.84)mmHg,(16.52±3.01)mmHg,(5.32±3.07)mmHg in the routine group(P<0.05).After surgery,best corrected visual acuity(BCVA)and uncorrected visual acuity(UCVA)in the knotless Z-su-ture group were(0.11±0.07)logMAR and(0.21±0.26)logMAR,which were slightly lower than(0.13±0.05)logMAR and(0.23±0.31)logMAR in the routine group,with no statistically significant differences(P>0.05).The score of visual function quality of life(VF-QOL)in the knotless Z-suture group was(85.12±16.07)points,which was significantly high-er than(74.98±16.32)points in the routine group(P<0.05).After surgery,diopter,spherical equivalent,and cylindrical equivalent in the knotless Z-suture group were(0.47±0.19)D,(0.13±0.21)D,and(-0.34±0.85)D,which were signifi-cantly lower than(0.61±0.32)D,(0.27±0.28)D,(-0.08±0.33)D in the routine group(P<0.05).After surgery,vertical ec-centricity of IOL in the knotless Z-suture group was(1.12±0.44)mm,which was significantly lower than(1.27±0.26)mm in the routine group(P<0.0

关 键 词：中重度囊袋 悬韧带支持不足 巩膜层间Z字缝合法 眼压 视功能 

分 类 号：R779.6[医药卫生—眼科]