人工晶状体Ⅱ期缝线固定术中眼压稳定的意义

Significance of the stable intraocular pressure during secondary ciliary sulcus suturing of intraocular lens

目的临床观察复杂外伤性白内障Ⅱ期人工晶状体睫状沟缝线固定术，术中稳定的眼压对手术操作的安全性及术后视觉效果的意义。方法人工晶状体睫状沟缝线固定术的外伤性白内障术后的无晶状体眼连续病例60例（60只眼），随机分为两组：观察组30例（30只眼）术中经睫状体平坦部置眼内BSS灌注通道控制眼压；对照组30例（30只眼）常规应用黏弹剂及BSS维持前房深度及眼球形态。分别于术后3个月及6个月观察两组患者的裸眼视力及最佳矫正视力、术中及术后并发症（包括角膜水肿、角膜散光、人工晶状体偏心倾斜等）。结果术后3个月，观察组视力优于对照组，两组患者的裸眼视力（t=2．297，P=0．025），最佳矫正视力（t=2．305，P=0．025）差异有统计学意义；术后6个月，裸眼视力观察组优于对照组（t=2．388，P=0．02），最佳矫正视力观察组也优于对照组（t=2．70，P=0．009）。观察组术中及术后并发症较对照组少，差异具有统计学意义。结论经平坦部置眼内灌注以保持眼压的稳定，有利于Ⅱ期人工晶状体睫状沟缝线固定术的手术操作，减少手术并发症，恢复良好的视觉功能。

Objective To study whether the stable intraocular pressure during secondary ciliary sul- cus suturing of intraocular lens played an important role in the surgical safety and visual outcome after opera- tion. Methods Sixty eyes of 60 patients with traumatic cataract were treated with ciliary suicus suturing of intraocular lens. The selected eases were divided into two groups randomly . Those 30 eases （30 eyes） with the placement of BSS intraocular perfusion system via the pars plana was the observation group. The others with Healon and BSS solution to maintain anterior chamber depth and eye shape was the control group. The uncorrected visual acuity（UCVA） and best corrected visual acuity（BCVA） at 3 months and 6 months after surgery , the intraoperative and postoperative complications （including corneal edema, corneal astigmatism, the eccentricity and tilt of IOL） were observed. Results At 3 months after operation,there were significant differences between two groups in the UCVA （t =2. 297 ,P =0. 025） and BCVA （t =2. 305 ,P =0.025）. 6 months after operation, the UCVA and BCVA in the observation group were better than the control group （t = 2. 388, P = 0. 02 ; t = 2. 70, P = 0.009 ）. The incidence of complications of the observation group was lower than the control group ＇ s significantly. Conclusion Intraocular perfusion system via pars plana can maintain stable intraoeular pressure during secondary ciliary sulcus suturing of intraocular lens which is important for safe surgical procedure and good visual outcome.