囊袋张力环在晶状体半脱位继发闭角型青光眼术中应用

Application of capsular tension ring in secondary angle closure glaucoma due to lens subluxation

目的探讨囊袋张力环在晶状体半脱位继发闭角型青光眼手术中应用的安全性及有效性。方法回顾性临床病例研究。对2007年9月至2012年3月在山东中医药大学附属眼科医院青光眼组收治的12例（14只眼）晶状体半脱位继发闭角型青光眼的患者，根据晶状体脱位的范围采用囊袋张力环或改良固定型囊袋张力环治疗，分析术后的眼压、视力及并发症。结果术后随访6个月至2年所有患者眼压恢复正常（不用任何降眼压药物），平均为（17．12±2．87）mm Hg，与术前相比差异有统计学意义（P〈0．01）。矫正视力有4只眼（28．57％）〉0．8：5只眼（35．71％）0．5-0．8；5只眼（35．71％）0．2-0．5。10只眼IOL位置居中，4只眼IOL轻度倾斜，无IOL夹持、脱位等并发症发生。3只眼出现后发障，行YAG后囊切开。无视网膜脱离等并发症。结论在合适的手术适应证和手术技巧条件下，囊袋张力环联合超声乳化人工晶状体植入及房角分离术对晶状体半脱位继发闭角型青光眼的手术治疗是安全有效的。

Objective To investigate the safety and effectiveness of capsular tension ring implan- tation in angle-closure glaucoma due to lens subluxation. Methods Retrospectively analyzed the clin- ical data of 12 patients （14 eyes） of glaucoma due to lens subluxation, capsular tension ring or im- proved capsular tension ring was implanted according to lens dislocation. Results The intraocular pressure of all patients returned to normal （without any ocular hypotensive drugs）, the average intra- ocular pressure （17.12±2.87） mmHg was statistically significant different （P 〈0.01） from preoperative. The best corrected visual acuity was significantly improved. IOL positions in 10 cases were normal, and in 4 eyes was slight tilt, no IOL clamping, no retinal detachment and other complications. Conclusions In appropriate operation indications and operation technique conditions, capsular tension ring combined with phacoemulsification and intraocular lens implantation and anterior chamber angle separation is safe and effective in angle-closure glaucoma due to lens subluxation.