眼外伤晶状体玻璃体切除术后二期IOL植入术

Secondary intraocular lens implantation after traumatic vitrectomy and lensectomy

目的 探讨复杂性眼外伤玻璃体切除术后无晶状体眼二期人工晶状体植入术临床疗效 ,评估手术的可行性及安全性。方法 手术 3 1例 (3 1眼 ) ,术后随访 3～ 2 0月 ,观察视力、散光度、眼压及并发症。结果 3 0眼术后裸眼视力均达到或接近术前矫正视力。后房型人工晶状体睫状沟植入 7眼中视力≥ 0 5者占 2 8 5 7% ,后房型人工晶状体透巩膜睫状沟缝线固定术 18眼中视力≥ 0 5者占 2 2 2 2 % ,虹膜型人工晶状体植入术 6眼中视力≥ 0 5者占 3 3 3 3 %。 1眼视力下降。结论 复杂性眼外伤行玻璃体切除术后二期人工晶状体植入 ,经过术前病例的选择 ,术中采用眼内灌注 ,适宜的人工晶状体植入 ,可获得较好的视力。

Objective To sutdy the clinical effect of intraocular lens(IOL) implantation after vitrectomy and lensectomy for complicated trauma.Methods 31 patients (31 eyes) of aphakic eyes from previous lensectomy and vitrectomy for complicated ocular trauma received different types of intraocular lens implantation respectively.Posterior chamber IOL was implanted in the ciliary sulcus in 7 eyes,trans-scleral suture fixation of posterior chamber IOL in 18 eyes and IOL with artificial iris in 6 eyes.The follow-up time was 3-20 months.Results Post-operative un-corrective vision of 30 eyes achived their pre-operative corrective vision.Only 1 eye's vision decreased.In the 7 eyes of posterior chamber IOL implantation,2 of them got 0.5 or better visual acuity (29.57%);In 18 eyes of trans-scleral suture fixation of posterior chamber IOL,4 of them got 0.5 or more (22.22%);In 6 eyes of IOL with artificial iris implantation,2 eyes gained 0.5 or better (33.33%).Conclusion Satisfied post-operative vision could be expected after secondary IOL implantation complicated traumatic cases following vitrectomy,depending on careful patients selected and proper type of IOL.