无囊膜支撑无晶状体眼Artisan人工晶状体植入术的疗效
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Artisan intraocular lens implantation in aphakic eyes without capsule support
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    摘要:

    目的:探讨无囊膜支撑的无晶状体眼植入Artisan人工晶状体的有效性和安全性。

    方法:前瞻性地分析24例24眼无囊膜支撑的无晶状体眼植入虹膜固定Artisan人工晶状体的手术后结果。纳入病例包括外伤性晶状体脱位、视网膜脱离或球内异物行晶状体玻璃体切除术后及晶状体摘出术后囊膜缺失。手术前后进行完整的眼部检查,包括裸眼视力、眼压、角膜内皮计数、瞳孔形态、人工晶状体固定情况、虹膜玻璃体视网膜情况,记录手术中和手术后出现的并发症。

    结果:患者随访12~24mo。所有手术眼视力均有提高,手术前裸眼视力为手动~0.2(logMAR 1.91±0.89),手术后末次随访裸眼视力为0.2~1.0(logMAR 0.46±0.59)。手术后1,3,12mo术眼平均等效球镜度数分别为-1.26,-0.43,-0.35D,±2.0D以内者术后3mo和12mo分别占66.7%和83.3%,±1.0D以内者分别占41.7%和50%。手术前及术后3,12mo眼压分别为16.95±7.85,12.38±4.68,15.96±5.25mmHg。手术前及手术后3,12mo平均角膜内皮计数分别为2 493.8,2 270.3,2 263.7个/mm2,手术后1~3mo,4~12mo内皮细胞丢失率分别为8.96%,0.27%,手术后12mo内皮细胞总丢失率为9.23%。手术后无持续性葡萄膜炎,虹膜无明显手术损伤和萎缩,瞳孔形态无变化,Artisan人工晶状体正位牢固固定,对玻璃体视网膜无影响。玻璃体切除眼手术中使用前房灌注可避免眼球塌陷。

    结论:无囊膜支撑的无晶状体眼植入虹膜固定Artisan人工晶状体是有效和安全的方法,但仍需要长期的随访观察以进一步对Artisan人工晶状体植入术作出评价。

    Abstract:

    AIM: To evaluate the efficacy and safety of Artisan intraocular lens implantation in aphakic eyes without capsule support.

    METHODS: Twenty-four consecutive aphakic eyes without capsule support of 24 patients were submitted to the surgery of an Artisan intraocular lens implantation. Uncorrected visual acuity, intraocular pressure, manifest refraction, endothelial cell count, Artisan intraocular lens fixation, influence on pupil, iris, vitreous, retina and clinical complications were evaluated.

    RESULTS: Mean follow-up time was 17(12-24)months. Uncorrected visual acuity increased in all cases. Mean spherical equivalent was -0.35 diopter 12 months postoperatively. Preoperative and postoperative intraocular pressure were 14.85±3.91mmHg and 14.37±3.92mmHg respectively. Mean endothelial cell loss was 9.23% 12 months postoperatively. The cell loss occurred predominantly during the first 3 months(8.96%). No serious complications were observed.

    CONCLUSION: Artisan intraocular lens implantation is a safe and effective procedure for aphakic eyes without capsule support. Long term evaluation is still necessary.

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杨广宇,孙兴怀,邹文军,等.无囊膜支撑无晶状体眼Artisan人工晶状体植入术的疗效.国际眼科杂志, 2013,13(5):1008-1010.

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  • 收稿日期:2012-12-04
  • 最后修改日期:2013-04-15
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  • 在线发布日期: 2013-05-06
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