人工晶状体脱位的病因分析及手术处理策略  

Etiological analysis and surgical strategies for intraocular lens dislocation

作　　者：王馨悦 陈天慧 蒋永祥 WANG Xinyue;CHEN Tianhui;JIANG Yongxiang(Eye Institute and Department of Ophthalmology,Eye&ENT Hospital,Fudan University,Shanghai 200031,China)

机构地区：[1]复旦大学附属眼耳鼻喉科医院眼科,上海200031

出　　处：《中国眼耳鼻喉科杂志》2024年第4期329-334,共6页Chinese Journal of Ophthalmology and Otorhinolaryngology

摘　　要：人工晶状体(IOL)脱位是白内障手术后一种严重的并发症,可给患者的视力和生活质量带来巨大的影响。根据发病的时间,可将其分为早期和晚期IOL脱位,两者在临床表现、病因及治疗等方面都有较大区别。其中,早期IOL脱位主要由术中操作不当所致;而晚期囊袋内IOL脱位主要是因为悬韧带进行性松弛、断裂及囊袋收缩,其危险因素包括假性剥脱综合征、高度近视等。IOL脱位程度较轻时可保守治疗,较重时则需要手术治疗。本文回溯了IOL脱位的病因,重点阐述了晚期囊袋内IOL脱位的发病机制及危险因素,并综述了目前IOL脱位最常见的手术方式。Intraocular Lens(IOL)dislocation is a serious complication following cataract surgery,leading to substantial impacts on patients'vision and quality of life.According to the timing of occurrence,IOL dislocation can be categorized into early and late in-the-bag dislocation,which are significantly different in clinical presentations,etiology,and treatment approaches.Early IOL dislocation is primarily due to intraoperative mishandling,while late in-the-bag IOL dislocation is mainly caused by progressive zonular laxity and rupture,as well as capsular contraction.Risk factors for late in-the-bag dislocation include pseudoexfoliation syndrome and high myopia.Mild IOL subluxation may be treated conservatively,while severe cases require surgical interventions.This review discusses the etiopathogenesis of IOL dislocation,with a focus on the pathogenesis and risk factors of late in-the-bag IOL dislocation,and summarizes the most common surgical techniques for IOL dislocation.

关 键 词：人工晶状体 人工晶状体脱位 假性剥脱综合征 人工晶状体固定术 人工晶状体置换术 

分 类 号：R776[医药卫生—眼科]