晶状体半脱位白内障的手术治疗

Surgical treatment of subluxated cataracts.

目的探讨晶状体半脱位白内障治疗的有效方法。方法对晶状体悬韧带部分断裂致26例（26眼）晶状体半脱位及白内障中14例行囊袋张力环植入晶状体超声乳化吸出人工晶状体植入术，8例行小切口白内障囊外摘出囊袋内人工晶状体植入术，4例行小切口白内障囊外摘出睫状沟人工晶状体固定术，伴有玻璃体脱出的行前段玻切术。术后观察视力及手术并发症。结果所有患者术后视力均有提高，术后1周，视力为0．1～0．4者8眼，0．5～0．8者18眼；术后3个月，视力为0．1～0．4者6眼，0．5～0．8者20眼。术后1年散瞳1眼人工晶状体略下移，无复视或视力下降。术中术后均无严重并发症发生。结论根据悬韧带断裂情况和晶状体核硬度选择合适的手术方式，并掌握熟练的手术技术，晶状体半脱位白内障可取得良好的手术效果。

Objective To discuss the effective surgical treatment of subluxated cataracts with partially zonular dialysis. Methods For 26 cases （26 eyes ） of subluxated cataracts patients, phacoemulsufication with foldable intraocular lens （IOL） implantation after capsular tension ring insertion was performed on 14 eyes of 14 cases, cataract extraction through small scleral tunnel incision with intracapsular IOL implantation was performed on 8 eyes Of 8 cases, cataract extraction through small scleral tunnel incision with sulcus fixated IOL implantation was performed on 4 eyes of 4 eases, anterior virectomy was performed when necessary. The visual acuity and postoperative complicatioins were observed and analyzed. Resuits The visual acuity （VA） was increased in all patients postoperatively. 1 week after the operation, the VA was 0.1 - 0.4 in 8 eyes and 0.5 - 0.8 in 18 eyes. 3 months after the operation, the VA was 0. 1- 0.4 in 6 eyes and 0.5 - 0.8 in 20 eyes. 1 year postoperatively, the IOL position was found to be diverged a little after dilation of the pupil in 1 eye, no diplopia or VA decrease were observed. Conclusions If the optimal surgical method is chosen according to the extent of zonular dialysis and nuclear hardness and perfect skill is grasped, a satisfactory result can be obtained for sub luxated cataracts.