囊袋内超声乳化后房型人工晶状体植入治疗马凡综合征晶状体半脱位

Intracapsular phacoemulsification and posterior chamber intraocular lens implantation of Marfan syndrome lens subluxation

目的探讨马凡综合征晶状体半脱位安全有效地手术治疗方法。方法对2004年10月至2009年6月在淮南晨光眼科医院就诊的马凡综合征晶状体半脱位患者14例23只眼采用囊袋内超声乳化后房型人工晶状体植入术治疗。23只眼中晶状体半脱位〈90度者4只眼，90～120度者15只眼，120～180度者3只眼，〉180度者1只眼。手术方式为先用剪刀在晶状体中上部“一”字形水平剪开前囊膜，水分离，囊袋内超声乳化，黏弹剂推注清扫后囊膜，植入后房型人工晶状体，再撕除瞳孔区前囊膜，形成“口”字形囊袋，灌注吸除残余皮质。结果所有23只眼顺利植入后房型人工晶状体，术后观察3。24个月，视力恢复理想，人工晶状体基本居中，未见并发症。结论对于轻、中度马凡综合征晶状体半脱位的患者，采用囊袋内超声乳化，保留囊袋，原位植入后房型人工晶状体，可获得满意临床效果。

Objective To discuss a safe surgery method for treatment of Marfan syndrome lens subluxation. Methods Intracapsular phacoemulsification and posterior chamber intraocular lens implantation were performed on 14 cases （23 eyes） of Marfan syndrome lens subluxation. There were 4 eyes lens subluxation less than 90 degree, 15 eyes at 90 to 120 degree, 3 eyes at 120-180 de- gree, 1 eye at more than 180 degree. Surgery method was as following, horizontally cut the middle and upper anterior capsule, water dissection, intracapsular emulsification, used viscoelastic agent to polish the posterior capsule, implanted posterior chamber intraocular lens, tore the anterior capsule at the pupil region, suct the anterior chamber. Perfusion suction residual cortex. Results All surgeries were performed unevenfully. Observing 3 to 24 months postoperatively, visual acuity recovered well, intraocular lens were at good location, there were no complications. Conclusions Using intracapsular phacoemulsification and posterior chamber intracapsular intraocular lens implantation to treat mild and moderate Marfan syndrome lens subluxation can obtain satisfactory results.