摘要
目的探讨玻璃体切除联合人工晶状体巩膜无缝线固定术治疗外伤性晶状体不全脱位的疗效。方法对眼挫伤导致的晶状体重度不全脱位24例(24眼),采用闭合式玻璃体切除,晶状体切除或超声粉碎吸除,同时行人工晶状体巩膜无缝线固定术:距上方角膜缘2 mm处做巩膜切口,于3点、9点位角膜缘后2 mm处分别做巩膜穿刺口及该处的巩膜板层隧道,从上方巩膜切口送入人工晶状体,从3点、9点位巩膜穿刺口将其两襻夹出,塞入巩膜板层隧道内固定。结果术后1周所有患者的视力均提高,其中矫正视力≥0.3者21例(87.5%),与术前比较差异有统计学意义(P<0.05)。2例眼压高,经药物治疗后降至正常。术后6个月所有病例均无人工晶状体脱位,1例人工晶状体轻度偏斜,3例人工晶状体夹持,3例虹膜局部后粘连。结论对外伤性晶状体重度不全脱位,尽早处理晶状体并行人工晶状体巩膜无缝线固定术,能有效恢复视功能并控制眼压,人工晶状体固定确切,并发症少。
Objective To evaluate the dinical efficcy of vitrectomy combined with intraocular lens sclera sutureless fixation for traumatic subluxated lens. Methods TWenty-four serious cases (24 eyes) with traumatic sublux- ated lens were treated with pars plarta vitrectomy combined with intraocular lens sclera sutureless fixation. Lens were treated with resection or ultrasonieation: Firstly, make scleral incision at a distance of 2 mm to the upper limbus of cornea; Secondly, punetore into vitreous chamber at 3 point, 9 point from 2 mm to the limbus of cornea and do the scleral lamellar tunnel puncture respectively; Thirdly, put intraocular lens into eyeball from the upper scleral incision; Fourthly, pull out lens haptics from 3 point, 9 point puncture; Finally, put lens haptics into scleral lameUar tunnel puncture. Results The visual acuity in all cases increased at the 1st week after surgery. 21 cases 87.5% had better corrected visual acuity than 0.3 and the difference had a statistical significance P 〈 0.05. High intraocular pressure was found in 2 cases and return normal with treatment, six month after operation, all the cases had no intraocular lens dislocation. 1 case of intraocular lens occurred light deflection, 3 cases ofintraocular lens occurred clamping, and 3 cases occurred partly posterior syneehia of the iris. Conclusion The traumatic subluxated lens in large scale should be given vitrectomy as early as possible. Intraocular lens sclera sutureless fixation is recommended at the same time. This method can effectively improve visual function, control intraocular pressure, fix intraocular lens exactly and decrease complications.
出处
《海南医学》
CAS
2014年第6期888-890,共3页
Hainan Medical Journal