眼外伤患者晶状体玻璃体切除术后Ⅱ期人工晶状体植入术

Secondary intraocular lens implantation on aphakic eyes after lensectomy combined with vitrectomy

目的 探讨眼外伤患者晶状体玻璃体切除术后无晶状体眼Ⅱ期人工晶状体植入的手术技巧.方法 眼外伤患者晶状体玻璃体切除术后无晶状体眼42例（42眼）,采用玻璃体腔灌注维持眼压.5例于保留的晶状体前囊前植入后房型人工晶状体,37例采用外路法人工晶状体睫状沟固定术,其中3例为带虹膜隔的人工晶状体.结果 术后随访3～40个月.术后最佳矫正视力≥0.3者28例（66.67%）,术后最佳矫正视力优于或等于术前最佳矫正视力者31例（73.81%）.结论 晶状体玻璃体切除术后无晶状体眼Ⅱ期植入人工晶状体时,需玻璃体腔灌注调整眼压,最好采用外路法预置睫状沟固定缝线,用四线或两线法悬吊人工晶状体.

Objective To study operational skill of secondary intraocular lens implantation on aphakic eyes after lensectomy combined with vitrectomy. Methods Under vitreous cavity irrigation, 5 eyes were operated with posterior chamber intraocular lens implanted on the front of anterior lens capsule, while 37 eyes were operated as the secondary posterior chamber intraocular lens were implanted with external suture fixation at ciliary sulcus. Results During a follow-up of 3- 40 months, the best corrected visual acuity （BSCVA） of 28 eyes after operation was ≥0.3（66.7% ）,and the best corrected visual acuity （BSCVA） of 31 eyes after operation was better than the preoperative BSCVA （73.8%） . 3 eyes had anterior chamber hemorrhage during operation, and complications of lens decentration in 1 eye, lens tilt in 2 eyes, secondary glaucoma in 3 eyes, detachment of choroid in 2 eyes ,as well as vitreous hemorrhage in 2 eyes occurred after operation. Conclusions The vitreous cavity irrigation was a good way against hypoton as secondary intraocular lens implantation on aphakic eyes after lensectomy combined with vitrectomy. Lens implantation with external suture fixation at ciliary sulcus by four-point or three-point fixation must be preferred.