小切口无缝线人工晶状体内固定手术治疗晶状体脱位的效果观察  

Observation on the efficacy of sutureless small-incision intraocular lens fixation for lens subluxation

作　　者：李冬平[1] 周国宏[1] 刘佳[2] 原莉莉[1] Li Dongping;Zhou Guohong;Liu Jia;Yuan Lili(Eye Hospital of Shanxi Province,Taiyuan 030002,China;Department of Ophthalmology,Heping Hospital Affiliated to Changzhi Medical College,Changzhi 046000,China)

机构地区：[1]山西省眼科医院,太原030002 [2]长治医学院附属和平医院眼科,长治046000

出　　处：《中华眼外伤职业眼病杂志》2023年第8期595-599,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：山西省重点研发计划项目(201903D321119);山西省卫健委科研项目(2015067);山西省眼科医院科研基金项目(B201902)。

摘　　要：目的观察小切口无缝线后房型人工晶状体内固定治疗外伤导致的晶状体脱位的效果。方法回顾性病例系列研究。收集2020年1月至2020年12月山西省眼科医院收治的眼外伤导致严重晶状体脱位36例(36眼)的临床资料。所有患者经小切口无缝线人工晶状体内固定术植入后房型三片式人工晶状体,观察术前及术后3个月的视力(logMAR,BCVA)、角膜内皮细胞密度、人工晶状体偏心量和倾斜度以及眼部并发症。结果术前BCVA为0.59±0.21,术后3个月提高为0.21±0.19,差异有统计学意义(t=1.76,P<0.001);术前角膜内皮细胞密度为(1978±246.70)个/mm^(2),术后3个月减少为(1877.12±339.76)个/mm^(2),差异无统计学意义(t=0.98,P>0.05),术后3个月测量人工晶状体倾斜度为2.11°±1.60°,偏心量为0.52°±0.19°。眼部并发症包括一过性高眼压2例(5.60%,2/36),轻度玻璃体积血1例(2.80%,1/36),前房纤维渗出2例(5.60%,2/36),未发生严重的眼部并发症。结论小切口无眼内缝线人工晶状体内固定可安全有效地治疗眼外伤导致的严重晶状体脱位,改善患者视力,人工晶状体位置正,且无严重的并发症。Objective To observe the efficacy of sutureless small-incision intraocular lens fixation for traumatic lens subluxation.Methods This was a retrospective series case study.The clinical data of 36 eeys of 36 cases of patients with traumatic lens subluxation who went to Shanxi Eye Hospital from Jan.to Dec.2020 was analyzed.All cases underwent sutureless small-incision surgeries to fix the artificial lens.Visual acuity(BCVA,logMAR),density of corneal endothelial cells,eccentricity and tilt of artificial lens and complications were analyzed before and 3 months after operation.Results BCVA of preoperation and 3 months postoperatively were 0.59±0.21 and 0.21±0.19,respectively,the difference was statistically significant(t=1.76,P<0.001).The preoperative corneal endothelial cell densitiy was(1978±246.70)cells/mm^(2),and the postoperative corneal endothelial cell densitiy was(1877.12±339.76)cells/mm^(2).There was no statistically significant difference(t=0.98,P>0.05).At 3 months after surgery,the decentration of IOL was 2.11°±1.60°and the tilt was 0.52±0.19°.There were 2 eyes(5.60%,2/36)with elevated intraocular pressure,1 eye(2.80%,1/36)with mild vitreous hemorrhage,and 2 eyes(5.60%,2/36)with fibrinous exudation in the anterior chamber.Conclusion Sutureless surgery with small-incision for traumatic lens subluxation is an effective and safe method to improve patient’s visual acuity with perfect position of introcular lens and no severe complications.

关 键 词：晶状体脱位 外伤性 固定术 效果 

分 类 号：R779.6[医药卫生—眼科]