两种前房型人工晶状体治疗无晶状体眼的效果探讨

Efficacy of two kinds of anterior chamber intraocular lens for the treatment of aphakia

目的探讨无晶状体眼植入Artisan虹膜夹持型人工晶状体与房角支撑型人工晶状体术后的临床效果及差异。方法收集深圳眼科医院2009年1月至2011年3月住院接受人工晶状体植入术的无晶状体眼患者共37例,其中植入ARTISAN虹膜夹持型人工晶状体19例(19只眼),植入房角支撑型人工晶状体18例(19只眼)。比较术后裸眼视力、最佳矫正视力(BCVA)、角膜内皮细胞计数、眼压、角膜水肿发生率、并发症及人工晶状体的位置。随访时间至术后3个月。结果两组术后视力恢复良好,术后3个月的BCVA无统计学差异。术后3个月两组眼压差异无显著性。Artisan虹膜夹持型组术后3个月角膜内皮丢失率低于房角支撑型组,术后1周内角膜水肿发生率高眼压发生率及术后并发症发生率均较房角支撑型组低。两组术眼的人工晶状体位置均保持良好的居中性。结论 Artisan虹膜夹持型人工晶状体与房角支撑型人工晶状体都是治疗无晶状体眼的有效方法,两者比较,虹膜夹持型人工晶状体植入术损伤更小,更为安全,为较佳的手术方式。两者远期效果的比较尚待进一步观察。

Objective To investigate the efficacy and differences of Artisan iris clip lens implantation and angle fixed lens implantation for the treatment of aphakia.Methods 37 cases of aphakic patients（38 eyes） without posterior capsular were observed.19 cases（19 eyes） were implantated Artisan iris clip lens,18 cases（19 eyes）were implantated angle fixed lens.Naked visual acuity（VA）,Best corrected visual acuity（BCVA）,Corneal endothelial cell count（CECs）,Intraocular pressure（IOP） were observed and compared.Complication,comeal edema,and Intraocular lens（IOL） position were also observed.The follow-up time was 3 months.Results All patients have good restored visual acuity,with correct Intraocular lens（IOL） position at 3 months after operation.There was no significant difference between Artisan group and angle fixed lens group in BCVA and IOP at 3 months after operation.The corneal endothelial cell loss rate in Artisan group is lower than that in angle fixed lens group at 3 months after operation.The incidence rate of intraocular pressure elevation and comeal edema in Artisan group is lower at 1 week after operation.The incidence rate of complication in Artisan group is also lower.Conclusion Artisan iris clip intraocular lens implantation and angle fixed lens implantation are both effective therapy for aphakic eyes.Artisan iris clip intraocular lens implantation cause less tissual lesion and is safer than the latter,It seems to be an ideal therapeutic method for the treatment of aphakic eyes without posterior capsular support.The long-term efficacyis needed to be further observed.