后房型人工晶状体无缝线巩膜层间固定术的临床应用研究  

Clinical application study of using sutureless intrascleral fixation of posterior chamber intraocular lens

作　　者：张照华 林会儒 李学民[2] Zhaohua Zhang;Huiru Lin;Xuemin Li(Department of Ocular Trauma and Fundus Diseases,Shandong Lunan Eye Hospital,Linyi 276002,China;Department of Ophthalmology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]山东省鲁南眼科医院眼外伤与眼底病科,临沂276002 [2]北京大学第三医院眼科中心,100191

出　　处：《中华眼科医学杂志(电子版)》2024年第5期276-280,共5页Chinese Journal of Ophthalmologic Medicine(Electronic Edition)

基　　金：首都卫生发展科研专项项目(首发2024-2-40913)。

摘　　要：目的观察后房型人工晶状体无缝线巩膜层间固定术在无囊膜眼和晶状体全(或不全)脱位眼中应用的临床效果。方法收集2022年11月至2023年11月于山东省鲁南眼科医院无囊膜眼17例(17只眼)和晶状体全(或不全)脱位18例(18只眼)行后房型人工晶状体无缝线巩膜层间固定联合前段或全段玻璃体切除术的临床资料。术后随访3~12个月,观察术后裸眼视力(UCVA)、最佳矫正视力(BCVA)、眼压、人工晶状体稳定性及手术并发症。UCVA、BCVA、眼压及散光屈光度符合正态分布,采用±s进行描述,术前和术后比较采用配对t检验。结果本研究无囊膜眼17例(17只眼),占48.57%。其中,1例(1只眼)需行前段玻璃体切除术,占5.88%;晶状体全脱位8例(8只眼),晶状体不全脱位10例(10只眼),合并高眼压8例(8只眼),分别占22.86%、28.57%及22.86%。术前术后UCVA分别为(1.56±0.63)最小分辨角对数(logMAR)和(0.50±0.44)logMAR,差异有统计学意义(t=8.60,P<0.05)。术前术后BCVA分别为(0.73±0.56)logMAR和(0.36±0.45)logMAR,差异有统计学意义(t=3.16,P<0.05)。术前术后眼压分别为(20.6±10.7)mmHg(1 mmHg=0.133 kPa)和(14.0±4.4)mmHg,差异有统计学意义(t=3.54,P<0.05)。所有术眼的人工晶状体位置居中,无明显偏移或倾斜现象。术后轻度玻璃体积血者2例(2只眼),占5.71%;眼压一过性升高者1例(1只眼),占2.86%;人工晶状体不全脱位者1例(1只眼),占2.86%。术中、术后随访期内无脉络膜下爆发性出血、视网膜脱离或眼内炎等严重并发症发生。结论后房型人工晶状体无缝线巩膜层间固定术可用于无囊膜眼或晶状体全(或不全)脱位患者的治疗,操作简单,相关并发症少,安全有效,具有临床推广价值。Objective The aim of this study is to observe the clinical efficacy of using sutureless intrascleral fixation of posterior chamber intraocular lens in eyes without capsular support and eyes with subluxation or complete luxation of lens.Methods The clinical data of 17 cases(17 eyes)without capsular support and 18 cases(18 eyes)with subluxation or complete luxation of lens treated with sutureless intrascleral fixation of intraocular lens,combined with anterior or complete vitrectomy,from November 2022 to November 2023 in Shandong Lunan Eye Hospital were analyzed retrospectively.The follow-up time was 3~12 months.The postoperative uncorrected visual acuity(UCVA),best corrected visual acuity(BCVA),intraocular pressure,stability of the intraocular lens,and surgical complications were observed.UCVA,BCVA,the intraocular pressure and astigmatism refractive error followed a normal distribution and were described using±s and used by paired t-tests for preoperative and postoperative comparisons.Results In this study,there were 17 cases(17 eyes)without capsular support,accounting for 48.57%,including 1 case(1 eye)requiring anterior vitrectomy,accounting for 5.88%;8 cases(8 eyes)of complete luxation of lens,accounting for 22.86%;and 10 cases(10 eyes)of subluxation of lens,accounting for 28.57%;with 8 cases(8 eyes)having elevated intraocular pressure,accounting for 22.86%.The preoperative and postoperative UCVA were(1.56±0.63)logMAR and(0.50±0.44)logMAR,respectively,with a statistically significant difference(t=8.60,P<0.05).The preoperative and postoperative BCVA were(0.73±0.56)logMAR and(0.36±0.45)logMAR,respectively,with a statistically significant difference(t=3.16,P<0.05).The preoperative and postoperative intraocular pressure were(20.6±10.7)mmHg(1 mmHg=0.133 kPa)and(14.0±4.4)mmHg,respectively,with a statistically significant difference(t=3.54,P<0.05).The position of intraocular lens in all eyes was centrally after surgery without apparent deviation or tilt.Postoperatively,two cases(2 eyes)had mild vitreous hemorrha

关 键 词：无囊膜 人工晶状体 巩膜 固定 无缝线 

分 类 号：R779.6[医药卫生—眼科]