巩膜“B”形埋线法在人工晶状体悬吊术中的应用

The use of the scleral ＂B＂-shaped embedding method for intraocular lens suspension surgery

目的探讨巩膜“B”形埋线法在人工晶状体悬吊术中应用。方法前瞻性系列病例研究。选择无晶状体或晶状体半脱位患者25例（27眼），对常规巩膜瓣下人工晶状体袢固定的方法进行改良，行“B”形埋线法固定人工晶状体袢，其中悬吊型人工晶状体23眼，带虹膜隔悬吊型人工晶状体4眼，有瞳孔变形、虹膜离断同时进行瞳孔缝合及根部离断修复。术后观察视力、畏光状况、有无缝线暴露、长充血等刺激症状、人工晶状体位置等。结果全部患者术后视力或畏光症状均有所改善。术后视力：0．05—0．6。术中睫状体出血1例，经升高眼内压止血，更换切口，玻璃体腔灌洗积血，之后手术顺利。所有病例观察6～12个月。随访期内无巩膜线结暴露、结膜充血等刺激症状，无感染。临床观察人工晶状体固定位置良好，无人工晶状体移位、倾斜现象。结论采用巩膜“B”形埋线法对传统人工晶状体悬吊术巩膜瓣下的晶状体袢固定切口进行改良，安全有效。

Objective To explore the use of the scleral ＂B＂-shaped embedding method for intraoeular lens suspension surgery. Methods Twenty-five patients （27 eyes） with aphakia or lens subluxation were selected for this prospective case series study. Intraocular lens suspension surgery was performed on all eyes. The ＂B＂-shaped embedding method was used to fixate the loop of the intraocular lens instead of using the traditional intraocular lens loop fixation under the scleral flap. The intraocular lenses included the suspension type （23 eyes） and the iris diaphragm suspension type. The eyes with pupil deformation and iris disarticulation were handled during the surgery. Results Visual acuity and photophobia symptoms improved after surgery. Visual acuity after surgery was between 0.05 and 0.6. Ciliary body bleeding during surgery occurred in 1 eye. The bleeding was resolved by increasing intraocular pressure, replacing the incision and vitreous cavity lavage hemorrhage. All patients were followed up for 6-12 months. There was no infection or uncomfortable symptoms caused by exposure of the scleral line knot and conjunctival hyperemia during the follow-up period. The position of the intraocular lens was normal without ectopic or oblique placement. Conclusion The traditional intraocular lens loop fixation under the scleral flap was improved. The use of the scleral ＂B＂-shaped embedding method is worth promoting to widen its acceptance.