人工晶状体无缝线桥型巩膜层间固定术与睫状沟缝线悬吊术后1年临床效果的比较  

Comparison of 1-year postoperative clinical effects between sutureless bridge intrascleral fixation and ciliary sulcus suture suspension of intraocular lens

作　　者：贾雍 田陌奇 郭丽莎 张百珂 廖沙 史臻 田学敏 JIA Yong;TIAN Moqi;GUO Lisha;ZHANG Baike;LIAO Sha;SHI Zhen;TIAN Xuemin(Department of Ophthalmology,No.988 Hospital of Joint Logistic Support Force of PLA,Zhengzhou 450042,Henan Province,China;Henan University of Chinese Medicine,Zhengzhou 450008,Henan Province,China)

机构地区：[1]中国人民解放军联勤保障部队第九八八医院眼科,河南省郑州市450042 [2]河南中医药大学,河南省郑州市450008

出　　处：《眼科新进展》2024年第2期106-111,共6页Recent Advances in Ophthalmology

基　　金：河南省自然科学基金(编号:202300420066);河南省医学科技攻关计划联合共建项目(编号:LHGJ20220915)。

摘　　要：目的对比分析人工晶状体(IOL)无缝线桥型巩膜层间固定术与睫状沟缝线悬吊术后1年的临床效果。方法回顾性分析2019年3月至2022年1月在联勤保障部队第九八八医院行IOL无缝线桥型巩膜层间固定术的患者14例(14眼)作为层间固定组,同期行IOL睫状沟缝线悬吊术的患者15例(15眼)作为缝线悬吊组。随访1年,检查并比较两组患者术前及术后裸眼视力(UCVA)、最佳矫正视力(BCVA)、等效球镜度数(SE)、角膜内皮细胞计数(ECC)、眼压及IOL位置等。结果术后1个月、6个月及12个月两组患者UCVA均较术前提高,差异均有统计学意义(均为P<0.05),且术后各时间点层间固定组患者UCVA均好于缝线悬吊组(F=4.560、6.411、5.373,均为P<0.05)。术后1个月、6个月及12个月两组患者的BCVA与术前比较,差异均无统计学意义(均为P>0.05),但术后各时间点,层间固定组患者的BCVA均优于缝线悬吊组(F=6.170、6.957、10.624,均为P<0.05)。术后层间固定组表现为远视漂移,缝线悬吊组表现为近视漂移。术后1个月、6个月及12个月,层间固定组患者SE分别为(0.59±0.30)D、(0.57±0.27)D和(0.64±0.29)D,缝线悬吊组患者分别为(-0.75±0.44)D、(-0.72±0.42)D和(-1.12±0.64)D。两组患者术后6个月ECC均较术前明显降低(t=8.579、21.929,均为P<0.001)。两组所有术眼术前眼压均在正常范围内,随访期间眼压平稳。随访期间IOL位置均居中,未见明显偏心及倾斜,无玻璃体、视网膜并发症发生。结论IOL无缝线桥型巩膜层间固定术与睫状沟缝线悬吊术后均可使患者获得较好的预后视力,都存在屈光漂移,但无缝线桥型巩膜层间固定术临床效果更佳。Objective To compare the clinical effects between sutureless bridge intrascleral fixation and ciliary sulcus suture suspension of intraocular lens(IOL)1 year postoperatively.Methods In this retrospective study,14 patients(14 eyes)who underwent sutureless bridge intrascleral IOL fixation in the No.988 Hospital of Joint Logistic Support Force of PLA from March 2019 to January 2022 were taken as the intrascleral fixation group and 15 patients(15 eyes)who underwent IOL ciliary sulcus suture suspension in the same period were taken as the suture suspension group.During the 1-year follow-up,the preoperative and postoperative uncorrected visual acuity(UCVA),best corrected visual acuity(BCVA)(logMAR),spherical equivalent(SE),endothelial cell count(ECC),intraocular pressure(IOP)and IOL position were compared between the two groups.Results At 1,6 and 12 months postoperatively,the UCVA in both groups significantly increased compared with those before surgery(all P<0.05),and UCVA in the intrascleral fixation group were better than those in the suture suspension group at all postoperative time points(F=4.560,6.411 and 5.373;all P<0.05).At 1,6 and 12 months postoperatively,there was no significant difference in BCVA in both groups compared with those before surgery(all P>0.05),but BCVA in the intrascleral fixation group were better than those in the suture suspension group at all postoperative time points(F=6.170,6.957 and 10.624;all P<0.05).After surgery,eyes in the intrascleral fixation group showed hyperopia drift,while eyes in the suture suspension group showed myopia drift.At 1,6 and 12 months postoperatively,the SE of the intrascleral fixation group were(0.59±0.30)D,(0.57±0.27)D and(0.64±0.29)D,respectively,and those of the suture suspension group were(-0.75±0.44)D,(-0.72±0.42)D and(-1.12±0.64)D,respectively.At 6 months postoperatively,the ECC of both groups were significantly lower than those before surgery(t=8.579 and 21.929;both P<0.001).The IOP in both groups were within the normal range preoperatively and stab

关 键 词：人工晶状体 巩膜层间固定 睫状沟 缝线悬吊 屈光漂移 

分 类 号：R776[医药卫生—眼科]