目的：比较不同人工晶状体(IOL)固定术治疗缺少囊膜支撑的无晶状体患者的疗效。

方法：回顾性研究。选取2019年6月至2024年6月本院收治的缺少囊膜支撑的无晶状体患者120例120眼，根据治疗方式分为两组：A组60眼采用巩膜瓣下IOL深层巩膜固定术治疗； B组60眼采用睫状沟IOL缝线悬吊固定术治疗。比较两组患者手术时间，术前，术后1、3、6 mo裸眼视力(UCVA)、最佳矫正视力(BCVA)、眼压(IOP)、角膜内皮细胞密度(CECD)、角膜内皮细胞丢失率和术后并发症。

结果：A组患者手术时间小于B组(24.69±2.69 vs 32.75±3.75 min，t=11.937，P<0.05)。两组患者术后UCVA和BCVA均较术前改善，且A组优于B组(均P<0.05)； A组角膜内皮细胞丢失率在术后1、3、6 mo均小于B组，术后1 mo A组的IOP小于B组，CECD高于B组(均P<0.05)； A组患者术后IOL异位3眼(5.0%)小于B组11 眼(18.3%，P=0.023)。

结论：巩膜瓣下IOL深层巩膜固定术治疗缺少囊膜支撑的无晶状体患者的疗效显著，有助于改善患者视力，手术时间较少，且术后并发症少。

METHODS:Retrospective study. Totally 120 cases(120 eyes)of aphakia patients who lacked capsule support admitted to our hospital from June 2019 to June 2024 were selected as the study subjects and randomly assigned into group A and group B, with 60 cases in each group. Group A underwent subcapsular IOL deep scleral fixation, while group B underwent IOL suture suspension fixation in the ciliary groove. The surgery time, uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), intraocular pressure(IOP), corneal endothelial cell density(CECD), corneal endothelial cell loss rate, and postoperative complications were compared between the two groups before and at 1, 3, 6 mo after surgery.

RESULTS:The operation time of the group A was lower than that of the group B(24.69±2.69 vs. 32.75±3.75 min, t=11.937, P<0.05). The UCVA and BCVA in both groups were better than those before operation, and the group A was better than the group B(all P<0.05). The loss rates of corneal endothelial cells in the group A were lower than those in the group B at 1, 3 and 6 mo after surgery, the IOP in the group A was lower than that in the group B at 1 mo after surgery, and the CECD in the group A was higher than the group B(all P<0.05). The 3 eyes(5.0%)of the postoperative IOL ectopic in the group A were less than 11 eyes in the group B(18.3%, P=0.023).

CONCLUSION:Subcapsular IOL deep scleral fixation has prominent curative effects on aphakic patients who lack capsule support. It helps improve vision, with less operation time, and fewer postoperative complications.