国际眼科纵览

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先天性晶状体半脱位的治疗进展

王安暕 樊琪 卢奕   

  1. 200031上海,复旦大学附属眼耳鼻喉科医院眼科
  • 收稿日期:2015-10-15 出版日期:2016-02-22 发布日期:2016-03-07
  • 通讯作者: 卢奕,Email:luyiox@163.com E-mail:luyiox@163.com

Treatment of congenital subluxated lens

WANG An-jian, FAN Qi, LU Yi   

  1. Department of Ophthalmology, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai 200031,China
  • Received:2015-10-15 Online:2016-02-22 Published:2016-03-07
  • Contact: LU Yi, Email: luyiox@163.com E-mail:luyiox@163.com

摘要:

先天性晶状体半脱位是眼科较复杂的一种疾病。目前,先天性晶状体半脱位的治疗仍以手术治疗为主,但手术方式和时机的选择尚有争论,手术操作的复杂程度也远大于普通白内障手术,且术后并发症多而复杂。近年来为了使患者术后拥有最佳的视觉体验与最少的并发症,各种手术技术与新的手术辅助工具都在不断完善。目前,最为经典的术式为经巩膜后房人工晶状体(intraocular lens, IOL)缝线固定术,而近年来缝线固定张力环和张力段的植入由于其术后长期并发症较少被运用得越来越多,部分术者则青睐虹膜夹IOL或虹膜缝线固定IOL。每种手术方式各有利弊,并发症不尽相同,术者需把握每种术式的时机与适应证,针对不同患者个性化选择治疗方案,控制并发症,才能取得好疗效。同时,新技术的不断开发使先天性晶状体半脱位患者获得更好的预后。

Abstract:

Congenital subluxation of the lens is a complicated disease in ophthalmology. At present, the treatment of congenital dislocation of the lens is still dominated by surgical management. However, the choice of surgical approach and timing is still in dispute. The complexity of the operation is far greater than that of the common cataract surgery, and postoperative complications are more complicated. Nowadays, in order to get better postoperative prognosis and the least postoperative complications, a variety of surgical techniques and new surgical tools are constantly improving. The trans-scleral suture-fixed posterior chamber intraocular lens(IOL) is the most classic surgery. Meanwhile, the implantations of suture-fixed capsular tension ring/segment are used more and more, due to little complications during long-term follow-up. Some surgeons favor iris-claw or iris-fixed IOL alternatively. Each surgical method has its own merits and faults. According to the indications and complications of each method, surgeons should choose the personalized medical therapies tailored to individual patients based on their condition. Furthermore, constantly development of new technologies will provide a better prognosis to the congenital lens subluxation patients.