人工晶体脱位或半脱位的处理

Management of dislocated or subluxated posteriorchamber intraocular lens

总结２０例（２０只眼）人工晶体脱位或半脱位的处理经验，２０例（２０只眼）均为白内障囊外摘除合并后房型人工晶体植入。术中发生者２例，术后发生者１８例，分别发生于术后第１天至３年不等。其中瞳孔夹持１２例，脱位于玻璃体内４例，“东西”综合征２例，“日落”和“日出”综合征各１例。２０例中，１例轻度“日落”综合征用缩瞳剂治疗；２例瞳孔夹持经保守治疗成功；１７例用手术治疗。手术治疗中，３例由原切口直接取出晶体；５例合并玻璃体手术取出晶体；９例瞳孔夹持采用手术复位，复位成功者７例，２例短期复位后复发。并讨论了人工晶体脱位或半脱位的原因及处理方法。

AbstractThe experiences of the management of 20 cases(20 eyes)of intraocular lens(IOL)dislocation orsubluxation were summarized in this report.All thepatients underwent primary extracapsular cataract ex-traction with posterior chamber IOL implantation.The dislocation or subluxation occurred in 2 eyesintraoperatively and 18 eyes in 1 day to 3 years,post-operatively.The IOLs were captured at pupils in12 eyes, dislocated into the vitreous in 4 eyes,repre-sented as in westeast svndrome in 2 eyes and sunsetand sunrise syndrome in 1 eye and 1 eye,respectively. Of the 20 eyes,1 eye with mild sunset syndrome was treated with a miotic,2 eyes with IOL pupillary cap-ture were treated successfully by conservative therapyand the rest, by surgeries.In cases treated by opera-tions,the IOLs were removed from original incisionsin 3 eyes,by vitrectomies in 5 eyes and surgicalreposition of IOLs were undertaken in 9 eyes with IOLpupillary capture of which 7 eyes were suceessful andin 2 eyes reeurrence took plaee shortly after reposition.The causes and management of IOL dislocation orsubluxation were discussed.