国际眼科纵览 ›› 2021, Vol. 45 ›› Issue (1): 6-11.doi: 10.3760/ cma.j.issn.1673-5803.2021.01.002

• 综述 • 上一篇    下一篇

前部巨眼及其白内障手术治疗进展

陈天慧 蒋永祥   

  1. 复旦大学附属眼耳鼻喉科医院眼科 国家卫生健康委员会近视眼重点实验室 中国医学科学院近视眼重点实验室 上海市视觉损伤与修复重点实验室,上海 200031
  • 收稿日期:2021-01-25 出版日期:2021-02-22 发布日期:2021-02-22
  • 通讯作者: 蒋永祥,Email:yongxiang_jiang@163.com E-mail:yongxiang_jiang@163.com
  • 基金资助:
    上海市科学技术委员会科技创新行动计划(18411965200);国家自然科学基金(81770908); 国家重点研发计划项目(2018YFC0116000)

Anterior megalophthalmos and its cataract surgery

Chen Tianhui, Jiang Yongxiang   

  1. Department of Ophthalmology,Eye and ENT Hospital of Fudan University; NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences; Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai 200031, China
  • Received:2021-01-25 Online:2021-02-22 Published:2021-02-22
  • Contact: Jiang Yongxiang, Email: yongxiang_jiang@163.com E-mail:yongxiang_jiang@163.com
  • Supported by:
    Shanghai Science and Technology Commission Scientific in Novation Action Plan (18411965200); National Natural Science Foundation of China (81770908); National Key Research and Development Program (2018YFC0116000)

摘要: 前部巨眼(anterior megalophthalmos),又称X连锁大角膜(X-linked megalocornea),是一种罕见的先天性眼前节发育不良疾病。90%前部巨眼患者为男性。前部巨眼的特征是角膜直径异常增大、深前房及睫状环增大,易合并早发白内障及晶状体不全脱位,严重威胁患者的视力。对于前部巨眼患者白内障及晶状体脱位手术而言,关键是选择合适的人工晶状体(intraocular lens,IOL)及手术方式。由于患者增大且不稳定的囊袋及脆弱的悬韧带,安全实施超声乳化的难度大,虹膜夹持型IOL植入或IOL睫状沟缝线固定的手术方式对于前部巨眼白内障患者可能是一种较为合适的手术方式。临床上如何根据前部巨眼白内障患者不同的囊袋特征进行个性化手术的选择来获得更优的手术效果,值得进一步的研究与探索。

关键词: 前部巨眼, 晶状体不全脱位, 人工晶状体

Abstract: Anterior megalophthalmos (AM), also called X\|linked megalocornea, is an rare congenital hypoplasia of ocular anterior segment. 90% of patients was approximately constituted by men. It is characterized by premature cataract and 360° zonular weakness with lens subluxation with megalocorneal, deep anterior chamber and the enlarged sulcus. Recently, cataract surgeries in AM patients still are a debatable point which is prone to challenge mainly because of zonular weakness and capsular bag. Characters of AM and cataract surgeries in AM patients remains unreviewed yet. For cataract and lens dislocation surgery in patients with AM, the proper choice of intraocular lens (IOL) and operation mode are the key points. It is difficult to implement phacoemulsification safely because of the large and unstable capsular bag and zonular weakness. Iris-claw IOL implantation or scleral fixated IOL implantation may be more suitable surgical way for AM patients. It is worthy of further research and exploration that how to choose individualized surgery according to different characteristics of capsular bag in AM patients in order to obtain better surgical effect.

Key words: anterior megalophthalmos, lens subluxation, intraocular lens