人工晶状体脱入玻璃体腔的原因及处理

CAUSES AND TREATMENT OF THE INTRAOCULAR LENS DISLOCATION INTO THE VITREOUS CAVITY

目的探讨后房型人工晶状体脱入玻璃体腔的原因及其处理方法。方法对14例(14眼)人工晶状体脱入玻璃体的原因及处理方法进行回顾性分析。观察患者手术前、后的视力及并发症情况,随访4～20个月。结果 14例患者均因白内障术中后囊破裂或悬韧带断裂而致人工晶状体脱位于玻璃体腔,经三通道玻璃体切割,取出脱位人工晶状体,13例行人工晶状体再植入或睫状沟巩膜悬吊术,1例因视网膜脱离未再植入人工晶状体。术后视力0.1～0.2者2眼,0.3～0.5的12眼,无严重并发症发生。结论人工晶状体脱入玻璃体的常见原因为后囊破裂、晶状体悬韧带断裂。经玻璃体切割后取出脱位人工晶状体,再植入合适的人工晶状体,是处理人工晶状体玻璃体脱位的有效方法。

Objective To explore the causes and treatment of the posterior chamber intraocular lens dislocation into the vitreous cavity.Methods Retrospective analysis was used in the causes and treatment of intraocular lens dislocation into the vitreous cavity in 14 cases（14 eyes）.The visual acuity before and after operations and the complications were observed.The follow-up period was 4 to 20 months.Results The 14 patients all suffered from dislocation of intraocular lens into the vitreous cavity because of rupture of the posterior capsule or suspensory ligament after cataract surgery.After vitreous cutting through the three-channel and removal of the dislocated intraocular lens,13 patients were given intraocular lens implantation or ciliary sulcus scleral suspension surgery.1 patient with retinal detachment did not have further intraocular lens implantation.After surgery,the visual acuity was 0.1 to 0.2 in 2 patients and 0.3 to 0.5 in 12 patients.No serious complications were found.Conclusion The common causes of intraocular lens dislocation into the vitreous carvity are the rupture of the posterior capsule and suspensory ligament.Implantation of proper intraocular lens by removal of the dislocated intraocular lens after vitreous cutting is an effective way of dealing with intraocular lens vitreous dislocation.