人工晶状体异位的原因和处理

Causes and management of dislocated intraocular lens

目的:分析人工晶状体位置异常的临床情况。方法:人工晶状体异位23眼包括人工晶状体玻璃体腔脱位、瞳孔夹持、"刮雨器(雨刷)"综合征等,原因为术中后囊膜破裂、后发性白内障、人工晶状体襻变形、外伤等,应用旋转复位法、后囊膜夹持固定法、玻璃体切除或加睫状沟缝线法等。结果:术后视力明显提高19眼,症状明显减轻至消失,人工晶状体位置固定。结论:提高人工晶状体植入手术技术是减少术后人工晶状体异位的主要措施,根据人工晶状体异位的不同情况应用各种复位技术可得到良好效果。

AIM： To analyze the causes of dislocated intraocular lens （IOL） and to evaluate the repositioning techniques. METHODS： The causes of dislocated IOL for 23 eyes were retrospectively analyzed, which included dislocated IOL into the vitreous cavity, papillary capture and windscreen wiper syndrome resulted from posterior capsule rupture during cataract extraction surgery, after cataract, damage of IOL haptics and trauma. The surgical approach to dislocated IOL included IOL repositioning into the ciliary sulcus without suturing, clamp technique of IOL on posterior capsule （ i. e. the optics of IOL was pushed behind the posterior capsule tear） and vitrectomy with or without IOL removal or ciliary sulcus scleral suture fixation. RESULTS： Nineteen eyes （83%） had stable IOL position and improved final vision. CONCLUSION： The cataract surgical technique is associated with dislocated IOL. Surgical management of dislocated IOL usually results in satisfactory visual outcomes.