外伤性晶状体脱位手术治疗105例回顾性分析
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Retrospective analysis of surgical strategies for traumatic lens dislocation in 105 cases
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    摘要:

    目的:分析不同类型、部位外伤性晶状体脱位的不同手术方法及预后。

    方法:回顾性分析我院2004-04/06间住院治疗的外伤性晶状体脱位患者105例105眼的临床资料。根据晶状体脱位的部位和类型不同,采用不同的手术方式:晶状体囊内摘除、超声乳化吸除、经睫状体平坦部切口玻璃体及脱位晶状体切除,同时根据不同的病情联合相应的手术方式如:玻璃体视网膜手术、抗青光眼手术。配对样本t检验比较术前及术后LogMAR视力。记录术中及术后并发症如脉络膜上腔驱逐性出血及复发性视网膜脱离的发生及处理。

    结果:所有患者均成功摘除脱位晶状体,术后视力与术前相比提高91眼(86.7%),视力达到0.1~0.3者42眼(40.0%),并有1眼晶状体半脱位患者术后视力达到了0.8以上。术中及术后发生脉络膜上腔出血各1眼,术后复发视网膜脱离2眼。

    结论:根据患者晶状体脱位的程度和部位不同,合理地选择手术方式或联合手术是治疗外伤性晶状体脱位的关键。脉络膜上腔驱逐性出血是外伤性白内障术中及术后最严重的并发性之一,需要恰当的处理及预防。

    Abstract:

    AIM: To retrospectively analyze the surgical strategies and outcome of traumatic lens dislocation.

    METHODS: Retrospective study. Clinical data of 105 cases(105 eyes)diagnosed with traumatic lens dislocation from April to June 2014 in our hospital were recruited. According to position of dislocated lens and complicated situations, different surgical approaches were performed, including intracapsular lens extraction, phacoemulsification, vitrectomy through pars plana and lensectomy.Meanwhile, vitreo-retinal or anti-glaucoma surgeries were performed in complicated cases.Preoperative and postoperative LogMar(Logarithm of the Minimum Angle of Resolution)visual acuity were compared by paired t-test. Perioperative complications including expulsive choroidal hemorrhages and recurrent retinal detachment were recorded and assessed.

    RESULTS: All 105 dislocated lenses were removed completely. Visual acuity of 91 eyes(86.7%)were significantly improved postoperatively.The visual acuity of most patients was 0.1-0.3(42 eyes, 40.0%)and 1 patient's visual acuity with lens subluxation reached more than 0.8 postoperatively. Expulsive choroidal hemorrhages occurred in 1 eye intraoperatively and 1 eye postoperatively. Recurrent retinal detachment was observed in 2 eyes postoperatively.

    CONCLUSION: According to position of the lens dislocation, personalized surgery strategy is critical for therapy of traumatic lens dislocation.Expulsive choroidal hemorrhage is one of most several complications and should be managed properly.

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郭省香,李晶明,惠巧艳,等.外伤性晶状体脱位手术治疗105例回顾性分析.国际眼科杂志, 2016,16(6):1089-1091.

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  • 收稿日期:2016-04-06
  • 最后修改日期:2016-05-17
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  • 在线发布日期: 2016-05-31
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