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马凡综合征晶状体半脱位超声乳化吸出人工晶状体植入 被引量:3

A clinical study of phacoemulsification and IOL implantation for lens subluxation in Marfan syndrome
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摘要 目的探讨马凡综合征半脱位晶状体超声乳化吸出悬吊型人工晶状体植入术的临床疗效。方法回顾性分析23例(38眼)马凡综合征半脱位晶状体临床资料,晶状体脱离范围均在一个象限以上。所有病例均进行经睫状体平坦部针刺晶状体托入前房行3.0mm小切口晶状体超声乳化吸出及闭合式前部玻璃体切除,并角膜缘隧道切口进行后房悬吊型人工晶状体植入睫状体沟缝线固定术。手术前最佳视力≤0.2者32眼,≥0.3者6眼,最佳矫正视力≤0.2者28眼。结果术后视力较术前明显提高,裸眼视力≤0.2者10眼,0.3~0.5者20眼,≥0.6者8眼。矫正视力≤0.2者5眼,0.3~0.5者19眼,≥0.6者14眼。人工晶状体位正且稳定。结论对于马凡综合征明显晶状体半脱位者,行晶状体针刺托入前房,透明角膜小切口行晶状体超声乳化吸出,前部玻璃体切除,悬吊型人工晶状体植入术,手术操作相对简单、损伤小、安全稳定、效果良好。 Objective To investigate the security and clinical effect of surgical treatment for Marfan syndrome:needling and pushing subluxated lens to anterior chamber,phacoemulsification through a small incision at transparence-cornea,anterior segment vitrectomy,and Suture fixation of posterior chamber intraocular lens implanta-tion.Methods We retrospectively observed clinical data of 38 eyes of 23 cases suffered from Marfan syndrome with significant lens sub-luxation.The ranges of lens subluxation in all these eyes were more than a quarter.Each eye was treated in the way as follows:needled from orbiculus ciliaris and pushed subluxated lens to anterior chamber,phacoemulsification was perfomed through a small incision of 3-millimeter-long at transparence-cornea,anterior segment vitr-ectomy was operated occlusively,a tunnel styled incision at limbus of cornea was employed and a intraocular lens was sutured go ciliary sulcus with two loops.Before operations,the best vision of 32 eyes was less than 0.2,that of the other 6 eyes was more than 0.3,the best-corrected vision of 28eyes was less than 0.2.Results All cases got obviously better postoperative.After surgery,the naked vision of 10 eyes was less than 0.2,20 eyes ranged from 0.3 to 0.6,and 8 eyes ranged fron 0.6 to 1.0.The best-corrected vision of 5 eyes was less than 0.2,19 eyes ranged from 0.3 to -.5,and 14 eyes ranged from 0.6 to 1.0.The intraocular lens was in the correct situation.Conclusion The technic of needling and pushing subluxated lens to anterior chamber,phacoemulsification through a small incision at transparence-cornea,anterior segment vitrectomy,and suspension method for intraocular lens implantion,is a relatively simple,less harmful,safe,and efficent therapy for the patients sufferd from Marfan syndrome with significant sublusated lens.
作者 贺严 李玉涛
出处 《眼外伤职业眼病杂志》 2010年第10期742-745,共4页 Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries
关键词 马凡综合征 晶状体半脱位 晶状体 人工 悬吊型 Marfan syndrome lens subluxation posterior chamber intraocular lenes(PCIOL)
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