超声生物显微镜在人工晶状体缝线固定术中的应用

The use of UBM in the intraocular lens suture fixated surgery

目的通过对超声生物显微镜(UBM)指导下设计人工晶状体缝线固定术的临床观察,为判定手术效果提供有效的临床依据。方法选取行人工晶状体缝线固定术者63例(63眼),术前行UBM检查并依此设计手术方式的35例为A组;术前未行UBM检查按常规术式植入人工晶状体的28例为B组。常规悬吊植入人工晶状体。记录术中进、出针位置及人工晶状体位置相关数据进行统计学比较。结果A组的进针位置位于角膜缘后平均(0.71±0.11)mm;B组进针位置位于角膜缘后1.0mm。两者的出针位置分别为(0.5588±0.3465)mm和(1.4404±1.0077)mm。A组中能确切植入睫状沟的襻数为46个(65.71%),而B组中仅6个襻(10.71%)能确切植入睫状沟。A组人工晶状体平均偏心(0.5588±0.3465)mm,平均偏位(0.4080±0.3559)mm;B组人工晶状体平均偏心(0.8095±0.1818)mm,平均偏位(1.1132±0.6609)mm。结论人工晶状体缝线固定术者术前常规行UBM检查,能提高人工晶状体襻睫状沟固定的准确性,减少术后人工晶状体偏心和偏位的发生。

Objective To investigate the intraocular lens （IOL） suture-fixated surgery under the guide of UBM examination. Methods 63 cases of the IOL suture-fixated surgery were selected,35 cases that in group A had undergone preoperative UBM examination and designed surgery. 28 cases that in group B had undergone routine surgery. The outer and inner position of needling and the position of IOL were checked. Results The outer location of needling of group A was 0. 71 ± 0. 11 mm behind the limbus;The outer location of needling of group B was 1 mm behind the limbus. The inner locations of needling was 0. 5588 ± 0. 3465 mm and 1. 4404 ± 1. 0077 mm respectively. In group A, 46 loop were precisely embedded in ciliary groove; Only 6 loop were precisely embedded in ciliary groove in group B. The average off center distance of artificial lens in group A were 0. 5588 ± 0. 3465 mm. The average dislocation distance was 0. 4080 ± 0. 3559 mm in group A;That of group B were 0. 8095 ±0. 1818 mm and 1. 1132 ±0. 6609 mm respectively. Conclusion The UBM examination can improve the acuity for the loop sulcus-fixation in IOL suture-fixated surgery, and reduce the rate of lens dislocalization.