晶状体后囊膜破损植入PCIOL的固定和观察

目的探讨常规PCIOL囊袋内植入和单襻或双襻睫状沟巩膜瓣下缝线固定术治疗晶体后囊膜破损的效果。方法回顾1997年10月～2006年10月我院白内障手术中的晶体后囊破损、无囊膜、晶体悬韧带断离等103例,均采用PCIOL不同植入法固定,取得了满意效果。结果随访6个月～8年。平均随访2年6个月。复查时最佳矫正视力1.0～1.2,最低视力0.25。视力在0.5以上者:后囊膜小破损32例(69.5%),缝线固定法:31例(54.3%)。视力偏低者,多有眼底病变或角膜云翳。二期植入者视力都高于术前矫正视力,眼压均在正常范围。103眼中,术后均无明显并发症发生。结论白内障摘除手术中,不管采用ICCE、ECCE、超声乳化(PHACO)及小切口法(SICS)等遇到晶体后囊膜破损、缺失或悬韧带断离等采用囊袋内植入(小破损)和睫状沟巩膜瓣下缝线固定法应是术者较理想的首选。

Objective To discuss the effect the conventional implantation in the capsular bag with PCIOL and sutured intraocular of one or two haptics on to subscleral flap of ciliary sulcus on rupture of lens posterior capsular. Methods One hundred and three cases with rupture of lens posterior capsular, non-envelope and extension of the zonule in cataract surgery from October 1997 to October 2006 were reviewed retrospectively. Different ways were used of PCIOL implantation to fix, were used and had achieved good results. Results Within the following 6 months to 8 years, the best-corrected visual acuity when reexamined was 1.0- 1.2, the lowest was 0.25. There were 32 cases （69.5%） with rupture of lens posterior capsular and 31 cases （54.3%） with sutured intraocula whose visual acuities were above 0.5. Lower ones must have fundus changes or corneal nebula. Visual acuity of secondary PCIOL implantation was higher than preoperative corrected one and ocular pressure was quite normal. In 103 cases, there were no obvious postoperative complication. Conclusion During cataract surgery, when counter with rupture of lens posterior capsular, deletion and extension of the zonule in ICCE, ECCE, PHACO and SICS, the ideal way is in-the-bag implantation and scleral suture fixation of posterior chamber intraoeular lens.