囊袋张力环在高度近视白内障超声乳化及人工晶状体植入术中的应用

Application of capsular tension ring in high myopia phacoemulsification and intraocular lens implantation

目的:评价晶状体囊袋张力环在高度近视白内障联合低度数人工晶状体手术中的应用价值。方法:对427例549眼高度近视白内障患者行超声乳化白内障吸出术及后房型人工晶状体和囊袋张力环植入,术后随访3～18mo,测视力、眼压、散大瞳孔进行眼前节裂隙灯观察照像。结果:所有植入的人工晶状体均位于正位,术后3mo矫正视力>0.8者43眼,0.6～0.8者118眼,0.5者89眼,0.4者101眼,0.3者66眼,0.2者80眼,<0.2者52眼;术后1d眼压为3～47mmHg,一过性高眼压179眼,其中有1例患眼因术后高眼压无法药物控制而不得不取出CTR;随访18mo中有2例患眼发生视网膜脱离、5例患眼因发生后发性白内障而行激光治疗。结论:晶状体囊袋张力环在高度近视白内障联合低度数人工晶状体手术中的应用能防止晶状体悬韧带离断,使人工晶状体居中性更佳,并进而能有效防止后发性白内障和视网膜脱离的发生。

AIM： To evaluate the application value of a capsular tension ring （CTR in high myopia cataract surgery associated with low diopter intraocular lens （IOL） implantation. METHODS： Five hundred and forty-nine eyes of 427 patients with high myopia cataract had an implantation of a CTR during phacoemulsification associated with IOL implantation surgery. During 3-18 months＇ follow-up, visual acuity, intraocular pressure （lOP） and the anterior segment of eyes were measured by slit-lamp microscope. RESULTS： No IOL decentration was found. Postoperative visual acuity with correction greater than 0.8 in 43 eyes, 0.6-0.8 in 118 eyes, 0.5 in89 eyes, 0.4 in 101 eyes, 0.3 in 66 eyes, 0.2 in 80 eyes, less than 0.2 in 52 eyes at 3 months postoperatively, lOP of 549 eyes was 3-47mmHg at first day postoperatively, increase of lOP was found at 179 eyes only for a short time. CTR was removed from intraocular in 1 cases due to lOP increase beyond control. Retinal detachment was found in 2 cases at 18 months postoperatively. YAG laser posterior capsulotomy in 5 cases was performed due to posterior capsular opacity. CONCLUSION ： In eyes with either zonular dehiscence or weakness, application of CTR in high myopia cataract surgery associated with low diopter IOL implantation operation can prevent zonular dehiscence and IOL decentration and tilt, and may lead to prevent posterior capsular opacity and retinal detachment.