玻璃体切割术后无晶状体眼行Ⅱ期悬吊折叠IOL植入术的临床观察
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Clinical observation of the secondary suspensory foldable intraocular lens implanted in aphakia eyes after vitrectomy
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    摘要:

    目的:探讨玻璃体切割术后无晶状体眼行微创、精准Ⅱ期悬吊式折叠人工晶状体(intraocular lens,IOL)推注器植入的临床效果。

    方法:回顾性分析 2015-03/2016-03我院25例25眼玻璃体切割术后无晶状体眼患者,做透明角膜缘2.4mm切口,测度计定位2:00、8:00子午线,折叠IOL装入推注器植入,晶状体两襻悬吊线打结点测量与襻端距离等长。透明角膜缘辅助穿刺口放置灌注头持续灌注维持前房,人工晶状体“W”形悬吊线缝合固定于巩膜层。术后随访3~26mo,观察患者视力、眼压、角膜、IOL位置、眼底情况。

    结果:患者25眼术后1wk均达到术前最佳矫正视力,屈光状态在±1.5DC内,眼压正常。患者角膜内皮细胞数术前为2 394.33±201.31个/mm2,术后3mo为2 283.30±217.82个/mm2,差异无统计学意义(P>0.05)。手术前后角膜六边形细胞百分率:术前为(52.67±6.28)%,术后3mo为(51.81±6.41)%,差异无统计学意义(P>0.05)。手术前后中央角膜厚度:术前为541.10±40.31μm,术后3mo为543.10±41.77μm,差异无统计学意义(P>0.05)。1眼脉络膜下少量出血,1眼IOL坠入玻璃体,经玻璃体切割手术取出再植入。随访无IOL脱位、移位,无角膜失代偿、视网膜脱离等发生,无缝线裸露和排斥反应的发生。

    结论:玻璃体切割术后无晶状体眼行悬吊式折叠IOL推注器植入效果确切,采用微创、小切口、精准植入可增加安全度,减少并发症,提高术后效果。

    Abstract:

    AIM: To evaluate the clinical effects of secondary suspensory foldable intraocular lens(IOL)implanted in aphakia eyes after vitrectomy.

    METHODS: The clinical data were retrospectively analyzed in 25 eyes of 25 patients treated with secondary suspensory intraocular lens implantation after vitrectomy. The surgery was performed through a incision 2.4mm away from corneal edge, followed by solarometer positioning 8:00 and 2:00, and foldable intraocular lens was loaded and implanted by an injector, after that suspension line knot of lens was made, which length was equal to the distance between the loops of intraocular lens. The intraocular lens was fixed to sclera by a "W" shaped suspension suture. The patients were followed up for 3~26mo postoperatively, and visual acuity, intraocular pressure, cornea, anterior chamber reaction, intraocular lens position, fundus were observed.

    RESULTS: All patients received preoperatively best corrected visual acuity at 1wk after surgery, and the refractive condition was within±1.5 DC. The intraocular pressure was all normal. The number of corneal endothelial cells(n/mm2)was 2394.33±201.31 before surgery, and was 2283.30±217.82 at 3mo(P>0.05). The percentage of corneal hexagonal endothelials was52.67%±6.28% preoperatively, and came to 51.81%±6.41% at 3mo(P>0.05). The central corneal thickness(mm)was 541.10±40.31 at the beginning, and was 543.10±41.77 at 3mo(P>0.05). Small amount of bleeding under choroid occurred in one eye, and intraocular lens dropped into vitreous body in another. Dislocation or shifting of intraocular lens, corneal decompensation or retinal detachment was not observed.

    CONCLUSION: The clinical effect of secondary suspensory foldable intraocular lens implanted in aphakia eyes after vitrectomy was satisfactory. Minimal invasive surgery through small incision and accurate implantation are applied to increase safety while reducing complications, thus improve the effects of surgery.

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宋学英,王浩,杨惠春,等.玻璃体切割术后无晶状体眼行Ⅱ期悬吊折叠IOL植入术的临床观察.国际眼科杂志, 2018,18(2):346-348.

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  • 收稿日期:2017-09-27
  • 最后修改日期:2017-12-25
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  • 在线发布日期: 2018-01-19
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