人工晶状体摘出原因分析

The causes of removing the intraocular lenses in 13 cases

目的分析13例人工晶状体摘出的原因，探讨减少这种手术并发症的方法。方法人工晶状体摘出13例（13眼）。对摘出人工晶状体的原因、摘出人工晶状体的类型以及手术方法进行了分析。结果13例年龄8—64岁。原发病为外伤性白内障9例，年龄相关性白内障2例，先天性白内障1例，并发性白内障1例。人工晶状体摘出原因是人工晶状体脱位6例，人工晶状体移位6例，角膜内皮功能失代偿1例，继发性青光眼伴人工晶状体脱位1例。摘出的13枚人工晶状体有三片式硬晶状体6枚，单片式硬晶状体2枚，三片式折叠晶状体3枚，单片式折叠晶状体1枚和1枚前房型人工晶状体。8例在摘出人工晶状体后重新植人人工晶状体，5例未再植人。结论对复杂类型白内障的恰当处理、对常规白内障术中后囊破裂等并发症的正确处理、对植入人工晶状体类型及植入方法的正确选择是避免人工晶状体摘出并发症的积极措施。

Objective To analyze the causes of removing the intraocular lenses （IOLs） in 13 cases, and to investigate the prevention and the management to reduce the complication. Methods A retro- spective study was done in 13 cases （ 13 eyes） of removing IOLs in any conditions from March 2005 to Janu- ary 2011 in Xijing Hospital. We analyzed the causes and the management of removing IOLs, and the type of removed IOLs. Results In 13 cases, the range of age was 8 to 64 years old, mean age was （30 ＋ 17.3 ） years old. The primary ocular diseases were traumatic cataract in nine cases, age-related cataract in two ca- ses, congenital cataract in one case, and secondary cataract in one case. The causes of removing IOLs were dislocation to vitreous cavity, severe disconcentration, corneal endothelial dysfunction and uncontrolled secondary glaucoma with IOLs dislocation. Among the 13 removed IOLs, six pieces were 3-piece unfold PMMA IOLs, two pieces were 1-piece unfold PMMA IOLs, three pieces were 2-piece fold IOLs, one piece was 1- piece fold IOLs and one was anterior chamber l-piece IOLs. IOLs were replaced in 8 cases, and in the other 5 cases, IOLs were removed. Conclusion The positive methods avoiding removing IOLs include appropriate treatment of complicated cataract, correct treatment for ruptured posterior lens capsule, suitable IOL type and IOL implantation procedure.