人工晶体取出37例原因分析

Analysis the causes of taking out of intraocular lens in 37 cases

目的通过对人工晶体植入术后取出病例原因分析,探讨人工晶体植入手术适应症的选择以及并发症的防治.方法回顾我科1999年1月～2004年5月37例(37眼)人工晶体取出病例并进行临床分析.结果 37例人工晶体取出病例中,视网膜脱离15眼,人工晶体脱位10眼,大泡性角膜病变4眼,继发性青光眼3眼,人工晶体度数错误2眼,眼内炎3眼.其中人工晶体脱位行缝线固定术后视力恢复0.1～0.2有5眼,0.3～0.5有5眼;人工晶体度数错误置换人工晶体后视力恢复0.4和0.7;视网膜脱离、继发性青光眼人工晶体取出术后无晶体眼视力为光感、手动或数指,矫正视力最好0.1,复查时视网膜复位,眼压正常;大泡性角膜病变人工晶体取出术后矫正视力0.1～0.3.眼内炎人工晶体取出术后矫正视力为0.1～0.3.结论人工晶体植入术后严重的并发症是导致人工晶体取出的直接原因.减少人工晶体植入手术的并发症可有效避免术后的人工晶体取出,使患者无晶体眼得到较好的屈光矫正.

Objective To analysis the causes of taking out of intraocular lens postoperation,and explore surgery accommodation and prevent surgery complications. Methods The causes for 37 cases(37eyes)of lens being taken out from January 1999 to May 2004 were retrospectively analyzed. Results Among the 37 cases:15 cases with retina detachment,10 cases with dislocated intraocular lens,4 cases with bullous keratopathy,3 cases with secondary glaucoma,2 cases with artificial lens degree error,3 cases with endophthalmitis.Follow-up period was 1～24 months.The dislocated lens were extracted and fixed by suture through sclera and visual acuity was 0.1～0.2 in 5 cases,0.3～0.5 in 5 cases.Artificial lens of degree error was exchanged and visual acuity was 0.4 and 0.7.After intraochlar lens extracted,visual acuity were light perception,hand move,finger count in cases of retina detachment or secondary glaucoma,the best corrected visual acuity was 0.1.Reexamination found no retina detachment,intraocular pressure was normal.In bullous keratopathy cases,the corrected visual acuity was 0.1～0.3.In endophthalmitis cases,the corrected visual acuity was 0.1～0.3. Conclusions Severe complications are direct causes of taking out of intraocular lens postoperation.Reduce surgery complications will avoid taking out of intraocular lens postoperation effectively and give good correction to aphakia.