普通型囊袋张力环植入后二期睫状沟缝合固定治疗中重度晶状体不全脱位的效果

doi:10.13281/j.cnki.issn.1004-4469.2016.02.002

眼科

普通型囊袋张力环植入后二期睫状沟缝合固定治疗中重度晶状体不全脱位的效果

王志亮陈志敏张武林武卫静林志辉杨荣

054001河北省邢台市，河北省眼科医院河北省眼科学重点实验室河北省眼科研究所（王志亮、陈志敏、张武林、林志辉、杨荣）；054001 邢台市人民医院（武卫静）

收稿日期:2015-12-19 出版日期:2016-03-25 发布日期:2016-03-24
通讯作者: 王志亮，Email：wzl528@sina.com
基金资助:
邢台市科技计划项目（2015ZC099）

Second stage fixed to the ciliary sulcus of common capsular tension ring for moderate and severe lens subluxation

CHEN Zhi-min¹， ZHANG Wu-lin¹， WU Wei-jing²， LIN Zhi-hui¹， YANG Rong¹.

1. Hebei Province Eye Hospital, Xingtai 054001, China ; 2. Xingtai People's Hospital, Xingtai 054001, China

Received:2015-12-19 Online:2016-03-25 Published:2016-03-24
Contact: WANG Zhi-liang，Email：wzl528@sina.com

摘要/Abstract

摘要：

目的评价普通型囊袋张力环（CTR）植入后二期睫状沟缝合固定治疗中重度晶状体不全脱位的临床效果。设计回顾性病例系列。研究对象 2013年3月-2015年5月河北省眼科医院中重度晶状体不全脱位患者33例（45眼）。方法上述患者一期行超声乳化联合普通型CTR和人工晶状体（IOL）植入，3个月后行二期手术，使用聚丙烯线将普通型CTR缝合于睫状沟。术后随访3个月。主要指标 最佳矫正视力、全眼慧差、斯特列尔比率、IOL偏中心量、并发症情况。结果 45眼成功进行二期CTR睫状沟缝合固定。二期术后3个月最佳矫正视力0.6~1.0者32眼（71%），0.3~0.5者8眼（18%），0.1~0.2者5眼（11%）。45眼（100%）术后最佳矫正视力均较术前提高。一期手术后全眼慧差值平均（4.08±3.17）μm；二期手术后平均（0.39±0.10）μm（t=5.102，P=0.000）。一期手术后斯特列尔比率平均（0.035±0.018），二期手术后平均（0.164±0.041）（t=14.881，P=0.003）。一期手术后IOL偏中心量平均（3.02±0.47）mm，与晶状体脱位范围相关（r=0.634，P=0.012）。二期手术后IOL偏中心量平均（0.31±0.11）mm，与术前相比差异有统计学意义（t=17.298，P=0.000）；二期术后IOL居中性良好。二期术后眼压升高3眼，术后所有患者未出现黄斑水肿、囊袋收缩等并发症。结论普通型囊袋张力环植入术后二期睫状沟缝合固定是治疗中重晶状体不全脱位有效方法，并发症少。（眼科，2016, 25： 77-81）

关键词: 晶状体不全脱位, 囊袋张力环, 睫状沟

Abstract:

Objective To observe the clinical effects of common capsular tension ring(CTR) fixed in the ciliary sulcus at the second stage for moderate and severe lens subluxation. Design Retrospective case series. Participants 45 eyes of 33 patients with moderate and severe lens subluxation were treated and followed up in the Department of Cataract of Hebei Province Eye Hospital from March 2013 to May 2015. Methods At the first stage the common CTR and the intraocular lens(IOL) were implanted in the lens capsule after phacoemulsification. At the second stage the CTR were sutured to the ciliary sulcus with polypropylene suture three months after the first stage. All patients were followed up for 3 months. The postoperative best corrected visual acuity(BCVA), the visual quality, the center of the IOL and the complications were recorded. Main Outcome Measures The BCVA, ocular coma, Strehl ratio, the IOL offset, the complications. Results We successfully fixed the CTR in the ciliary sulcus in 45 eyes. The postoperative BCVA was 0.6~1.0 in 32 eyes(71%), 0.3~0.5 in 8 eyes(18%) and 0.1~0.2 in 5 eyes(11%). The BCVA improved after 3 months in all the 45 eyes. The mean ocular coma after the first stage was (4.08±3.17) μm, which improved to (0.39±0.10) μm after the second stage, the difference was significant (t=5.102, P=0.000). The mean Strehl ratio after the first stage was (0.035±0.018), which improved to (0.164±0.041) after the second stage, the difference was significant (t=14.881, P=0.003). This illustrated the visual quality increased. The mean IOL offset after the first stage was (3.02±0.47) mm, which improved to (0.31±0.11) mm, the difference was significant (t=17.298, P=0.000). The IOL offset at the first stage was correlated with the range of the lens dislocation(r=0.634, P=0.012). The intraocular pressure increased in 3 eyes. No complications such as macular edema or capsular contraction occurred. Conclusions The capsular tension ring fixed in the ciliary sulcus at the second stage was an effective treatment for moderate and severe lens subluxation． Separating operations into two stages reduces the difficulty and complications of surgery. (Ophthalmol CHN, 2016, 25: 77-81)

Key words: , lens subluxation；capsular tension ring；ciliary sulcus

王志亮陈志敏张武林武卫静林志辉杨荣 . 普通型囊袋张力环植入后二期睫状沟缝合固定治疗中重度晶状体不全脱位的效果[J]. 眼科, doi: 10.13281/j.cnki.issn.1004-4469.2016.02.002.

CHEN Zhi-min1， ZHANG Wu-lin1， WU Wei-jing2， LIN Zhi-hui1， YANG Rong1.. Second stage fixed to the ciliary sulcus of common capsular tension ring for moderate and severe lens subluxation[J]. Ophthalmology in China, doi: 10.13281/j.cnki.issn.1004-4469.2016.02.002.

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普通型囊袋张力环植入后二期睫状沟缝合固定治疗中重度晶状体不全脱位的效果

Second stage fixed to the ciliary sulcus of common capsular tension ring for moderate and severe lens subluxation

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