42例(43眼)后房型人工晶体缝线固定术观察

The clinic observing of 42 cases of ciliary groove suture of post chamber IOL

目的探讨人工晶体睫状沟缝合固定术在晶体囊内摘除术后、囊外术中囊膜破裂或晶体小带大范围的松解、以及外伤性白内障、晶状体脱位、玻璃体切割术后等无晶体囊膜的患眼中的应用.方法我院1997年1月～2004年8月间采用后房型IOL缝线固定术完成了42例(43眼),均获得满意效果.其中:1.晶体后囊膜破损在2个象限残存后囊膜者,以此为依托将一侧人工晶体襻置于其上,另侧襻睫状沟缝线固定,即'一点固定法'实施了7例.2.因严重外伤或晶体囊内摘除术后而无晶体后囊者,施行双襻睫状沟缝线固定,即'二点固定法'实施了35例(36眼).结果随访4～54个月,平均随访24个月复查时矫正视力最佳1.2,最低0.2,视力在0.6以上者22眼(占53.6%),视力偏低者多为角膜瘢痕或眼底病变所致.二期植入者术后视力均高于术前最佳矫正视力.眼压均在正常范围.43眼中,术后均无明显并发症发生.结论 IOL睫状沟缝线固定术是无晶体囊膜及晶体后囊膜破裂或晶体小带大范围松解的首选.

Objective Investigate the application of ciliary groove suture of intraocular lens in the following cases:lens capsule disappearing in intracapsule extraction and posterior capsule broken in extracapsular extration,lens ligament loose,injury cataract,lens dislocation and post vitrectomy. Methods From January 1997 to August 2003,42 cases(43 eyes)using of ciliary groove suture with posterior chamber type of intraocular lens all acquired satisfying result.1.There are 7 cases of posterior capsule broken and over 2 quadrants survived.We sutured the edge of the lens to the ciliary groove,which we called “1 point fix”.2.In 35 cases(36 eyes)with serious injury and posterior capsule disappearance because of ICCE,we sutured the lens to ciliary groove in two sites,it was called “2 point fix”. Results Following up 4～54 months(average 24 months),the BCVA was from 0.2 to 1.2 and 22 eyes′ vision were more than 0.6(53.6%).Poor vision was because of the corneal scar and fundal diseases.Transplanting the IOL secondarily made the vision better than pre operation BCVA.The IOP in all eyes were normal and all had no complication. Conclusions The method of IOL suturing to the ciliary groove is the best select to the lens with the posterior capsule broken or disappearance and large range ligaments loose.