玻璃体切除术后无晶状体眼二期人工晶状体缝线固定术

The clinical observation for the methods and skills of implanting IOL in to the eyes after vitrectomy

目的探讨玻璃体切除术后无晶状体眼经巩膜睫状沟二期人工晶状体固定术的手术方法及技巧。方法对81例（81眼）玻璃体切除术后无玻璃体、无晶状体眼施行在前房灌注下后房多类型人工晶状体巩膜睫状沟缝线固定术，术后随访3月～9年，观察临床效果及术中术后并发症。结果81例术中一次固定成功，术后裸眼视力均较术前提高，最佳矫正视力均达到或接近术前最佳矫正视力。术中6例少量出血，术后少数患者出现一过性低眼压、再次外伤后襻折断、黄斑水肿、人工晶状体襻扭曲，光学面倾斜、视网膜脱离、眼内炎等并发症。结论玻璃体切除术后无晶状体眼二期人工晶状体缝线固定，术中应注意维持眼压，选择适合缝线固定的人工晶状体，可减少术中、术后并发症。

Objective To determine the methods and skills of the operations, which implanting IOL into the eyes without vitreous or lens after vitrectomy, whether can help to decrease the complications. Methods IOLs were implanted into 81 eyes after vitrectomy with lensectomy and fixed in the ciliary grooves. The suture line was fixed on the sclera. The perfusion of the anterior chamber was operated. The clinical curative effect and the complications were observed 3 months to 9 years after operation. Results All operations suceed. The vision of 81 eyes was better after operation. But some complications still occurred such as bleeding during operation, temporary low IOP, broken loop because of trauma, macular edema, IOL loop, detachment of retina（RD） and endophthalmitis after operation. Conclusions During the operation, stable IOP and right IOL could help to decrease the complications. The methods and skills might have clinic value.