白内障术后晚期人工晶状体脱位的研究进展
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Research advances on late intraocular lens dislocation after phacoemulsification
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    摘要:

    晚期人工晶状体脱位是白内障超声乳化吸除伴人工晶状体植入术后最严重的晚期并发症之一,晚期人工晶状体脱位是指行白内障手术3mo以后的脱位。不同于早期人工晶状体脱位,晚期自发性人工晶状体脱位主要是由于悬韧带断裂和囊袋收缩,通常在白内障手术后数年才发生。近些年来,晚期自发性人工晶状体脱位的发生率逐渐升高,10a后的累计发生率为0.1%,25a后为1.7%。在白内障术后长期随访病例中,90%患者存在悬韧带功能不全和/或囊袋收缩。多个因素可能导致晶状体悬韧带的脆弱和囊袋收缩,其中50%患者中可以观察到囊膜剥脱综合征,是最常见的原因,其他原因包括高龄、高度近视、葡萄膜炎、创伤、既往玻璃体切割手术史、视网膜色素变性、特应性皮炎、糖尿病、既往曾发生过急性闭角型青光眼、患有结缔组织疾病。对于这些易感因素的认识,有助于我们以后对高风险患者进行必要的预防。

    Abstract:

    Late intraocular lens dislocation is one of the most severe late complications after phacoemulsification. It often occurs 3mo after the surgery. Different from early intraocular lens dislocation, late intraocular lens dislocation is caused by zonular dehiscence and contraction of the capsular bag many years after phacoemulsification. In recent years, the incidence of late intraocular lens dislocation gradually increases, having a risk of 0.1% after 10a and 1.7% after 25a. In the long-term follow-up patients who underwent cataract surgery, 90% had zonular insufficiency and capsular contraction. Among the multiple factors which may contribute to zonular weakness and capsular contraction, pseudoexfoliation is the most common cause, accounting for 50% of all the cases. Other risk factors include aging, high myopia, uveitis, trauma, previous vitreoretinal surgery, retinitis pigmentosa, diabetes mellitus, atopic dermatitis, previous acute angle-closure glaucoma attack, and connective tissue disorders. The understanding of these predisposing factors will suggest necessary preventions for high-risk patients in the future.

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杨安怀,胡焰山,李拓.白内障术后晚期人工晶状体脱位的研究进展.国际眼科杂志, 2017,17(9):1674-1677.

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  • 收稿日期:2017-03-24
  • 最后修改日期:2017-07-21
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  • 在线发布日期: 2017-08-22
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