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无缝线巩膜层间固定人工晶状体植入术用于囊膜支撑力不足患者的疗效观察

周丹  何雷  桑景荭   

  1. 100730首都医科大学附属北京同仁医院 北京同仁眼科中心 眼科学与视觉科学北京市重点实验室
  • 收稿日期:2017-11-27 出版日期:2018-11-25 发布日期:2018-12-11
  • 通讯作者: 何雷,Email:13701317892@163.com E-mail:13701317892@163.com

Efficacy of sutureless intrascleral fixated intraocular lens implantation for insufficient capsular support

ZHOU Dan, HE Lei,SANG Jing-hong   

  1. Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
  • Received:2017-11-27 Online:2018-11-25 Published:2018-12-11
  • Contact: HE Lei, Email: 13701317892@163.com E-mail:13701317892@163.com

摘要:

目的 评价无缝线巩膜层间固定人工晶状体(intraocular lens,IOL)植入对囊膜支撑力不足患者的治疗安全性和有效性。设计 回顾性病例系列。研究对象 2015年8月至2018年5月于北京同仁眼科中心行无缝线巩膜层间固定IOL植入术患者41例(42眼)。方法 回顾性分析患者性别、年龄、术后并发症,比较手术前后裸眼视力和最佳矫正视力及屈光状态。术后随诊3~36个月,平均(12.1±9.0)个月。主要指标 并发症、裸眼视力、矫正视力、屈光状态。 结果 术后并发症包括前房渗出3例(7.1%),轻度前房或玻璃体积血4例(9.5%),一过性高眼压6例(14.3%)和低眼压8例(19.1%),IOL夹持2例(4.8%),IOL襻暴露1例(2.4%)。术后末次随访裸眼视力(LogMAR)及最佳矫正视力(LogMAR)分别为0.93±0.75和 0.21±0.23,与术前裸眼视力(1.69±0.38)及最佳矫正视力(0.35±0.22)比较,均有统计学差异(Z=-5.652,P=0.000;t=6.290, P=0.000)。末次就诊时术眼屈光不正平均球镜度数(0.85±0.47)D,散光平均柱镜度数(1.20±0.51)D。结论 无缝线巩膜层间固定IOL植入术后IOL稳定性良好,对无囊膜支撑的患者安全有效。

关键词: 人工晶状体植入, 无缝线, 巩膜层间

Abstract:

Objective To evaluate safety and efficacy of sutureless intrascleral fixated intraocular lens (IOL) implantation for patients with insufficient capsular support. Design Retrospective case series. Participants 42 eyes of 41 patients who underwent sutureless intrascleral fixated IOL implantation in Beijing Tongren Eye Center during August 2015 to May 2018. Methods Gender, age, postoperative complication, uncorrected visual acuity (UCVA) , best-corrected visual acuity (BCVA) and refractive error were reviewed and analyzed statistically.  Main Outcome Measures Complication, UCVA, BCVA, and refractive error. Results Postoperative complications included anterior chamber fibrin exudation in 3 eyes (7.1%), mild hyphema or vitreous hemorrhage in 4 eyes (9.5%),transient high intraocular pressure (IOP) in 6 eyes (14.3%) and low IOP in 8 eyes (19.1%),iris capture of the IOL in 2 eyes (4.8%),exposure of the haptic of  IOL in 1 eye (2.4%). There were significant statistical differences between the postoperative UCVA (0.93±0.75,LogMAR) and BCVA (0.21±0.23, LogMAR) with preoperative UCVA (1.69±0.38, LogMAR) (Z=-5.652,P=0.000) and BCVA(0.35±0.22, LogMAR) (t=6.290, P=0.000). At the last postoperative visit, mean refractive errors were (0.85±0.47) DS; mean astigmatisms were (1.20±0.51)DC.  Conclusion Sutureless intrascleral fixated IOL implantation technique provides good IOL fixation with reliable VA improvement without severe postoperative complication. It is safe and useful for IOL implantation in eyes without sufficient capsule support.

Key words: intraocular lens implantation;sutureless; , intrascleral