晶状体玻璃体联合手术治疗外伤性晶状体脱位

The combined surgical treatment of traumatic lens dislocation

目的探讨晶状体玻璃体联合手术治疗外伤性晶状体脱位的治疗原则、疗效和预后。方法总结1999年4月至2004年4月间收治的73例(73眼)外伤性晶状体脱位的脱位类型、治疗方法及疗效。结果所有患者均成功地摘除脱位的晶状体,90.4%的患眼视力有不同程度提高;继发青光眼患者的眼压得到控制;合并视网膜脱离者,术后视网膜复位。结论外伤后晶状体脱位的治疗要根据脱位晶状体的所处位置、是否存在并发症而定。如果脱位晶状体导致视力障碍、继发青光眼或视网膜脱离时,联合手术的疗效满意,视力明显提高。

Objective To evaluate the surgical methods,effects and prognosis of lens-vitreous surgery in the treatment of lens dislocation by ocular blunt.Methods To analyze the results of 73 cases(73 eyes) of lens dislocation patients from years of 1999 to 2004.All the dislocated lens were removed by different methods which including:extracapsular cataract extraction and the intraocular lens implantation;removing the lens by lens spoon and combined with anterior vitrectomy;using closed pars plana vitrectomy to remove the lens and vitreous body;using the combined trabeculectomy or pars plana vitrectomy to treat the complications by lens dislocation.Results All dislocated lens were removed successfully.The vision of 90.4% patients was increased by some degrees.The intraocular pressure with secondary glaucoma was controlled.The retinal detachments of patietns were reattached.Conclusions The treatment of traumatic lens dislocation depended on its position and complicatios.For the patents with minor lens dislocation and no complication,it can be followed up.For the patients with decreased vision,secondary glaucoma,uveitis or retinal detachment,the dislocated lens should be removed.The results of combined surgery were satisfactory.