带虹膜隔后房型人工晶状体植入术的临床应用

Clinical application of implantation of P-C IOL with iris diaphragm

目的探讨治疗虹膜缺损的外伤性白内障或无晶状体眼的有效方法。方法总结、分析13眼外伤性白内障或无晶状体眼因虹膜缺损接受带虹膜隔后房型人工晶状体植人手术的术后疗效。随访时间6～20个月。其中人工晶状体Ⅰ期植入4眼，Ⅱ期植入9眼。13眼均植入德国Morcher公司生产的67G型单体型聚甲基丙烯酸甲酯（PMMA）后房型人工晶状体，其光学部直径5．0mm；光学部外周黑色环为虹膜隔，宽2．5mm，虹膜隔与光学部整体直径10．0mm；虹膜隔外连两个有缝线固定小孔的C形襻。人工晶状体总长12．5mm。除3例行白内障囊外摘出联合人工晶状体植入术外（其中1例同时植入晶状体囊袋张力环），余均为用10—0聚丙烯缝线行三点法后房型人工晶状体巩膜缝线法固定术。结果术后矫正视力1．0者1眼，0．5～0．8者4眼，0．1～0．4者5眼，〈0．1者3眼。全部患眼畏光症状消失。术后无人工晶状体脱位等并发症发生。结论带虹膜隔后房型人工晶状体植人手术是治疗虹膜缺损白内障或无晶状体眼安全、有效的疗法。

Objective To explore one effective way to treat traumatic cataract with iris coloboma or aphakia eye. Methods The posterior chamber intraocular lens （P-C IOL） with iris diaphragm was implanted into 13 eyes. All cases were followed up 6- to20 months. The IOL used in this study was type 67′G with 5 mm optical diameter provided by Gernlany-based Morcher Company. The diaphragm with 2.5 mm length was discerned as a black circle a- round the optical part to comprise the integral of 10 mm. A type C loop with 2 holes for fixation of suture was linked outside to the diaphragm. Totally, the length of IOL was 12.5 ram. The 3-point trans-scleral surgical process with 10-Opolypropylene suture was applied to fix IOL of 10 eyes. The other 3 eyes were performed with extracapsular cataract extraction in combination with IOL implantation and one of them was implanted into capsular tension ring simultaneously. Results Postoperatively, the visual acuity was recorded as follows 1.0（1 eye） ; 0.5-0.8（4 eyes） ;0.1-0.4（5 eyes） ; 〈 0.1 （ 3 eyes）. No photophobia or dislocation of lens was found after operation. Conclusion The implantation of P-C IOL with iris diaphragm is a safe and effective method to deal with traumatic cataract with iris coloboma or aphakia eye.