马凡综合症伴晶状体半脱位的手术治疗

Surgery for lens luxation of marfan's syndrome

目的对马凡综合症伴晶状体半脱位患者行超声乳化吸除联合人工晶体植入合并张力环植入或超声乳化吸除联合人工晶体悬吊两种手术方法的探讨和分析。方法对3例(3眼)合并晶状体半脱位(脱位范围<1/2象限)的患者行超声乳化吸除联合人工晶体植入合并张力环植入术;对10例(11眼)合并晶状体半脱位(脱位范围>1/2象限)的患者行超声乳化吸除联合人工晶体悬吊术,分析手术前后视力及并发症。结果随访3-24个月,13例患者视力有不同程度的提高,未发生视网膜脱离及葡萄膜炎等并发症。结论超声乳化吸除联合人工晶体植入合并张力环植入或超声乳化吸除联合人工晶体悬吊术是进行马凡综合症晶状体半脱位治疗的有效手术方式,临床应根据晶状体脱位情况的不同选择不同的手术方式。

Objetive To evaluate the surgery management and clinical effects of phacoemulsificaion combined with intraocular lens and capsular tension ring implantation or phacoemulsificaion with the suture-fixation of foldable intraocular lens for lens luxation of Marfan＇s syndrome. Methods We respectively reviewed 17 patients with lens luxation of Marfan＇s syndrome. 3 patients （3 eyes, dislocation range〈2 quadrant） were treated with phacoemulsificaion combined with intraocular lens and capsular tension ring implantation. And other 10 patients （11 eyes, dislocation range〉2 quadrant） were treated with phacoemulsificaion with the suture- fixation of foldable intraocular lens. Main outcome measures were visual acuity and complications. Results 14 eyes （13 patients） were enrolled. Correction visual acuity was found to be improved in all cases. Postoperative complications such as glaucoma and retinal detachment did not occur. The follow-up time varied from 3 to 24 months. Conclusion Both phacoemulsificaion combined with intraocular lens and capsular tension ring implantation, and phacoemulsificaion with the suturefixation of foldable intraocular lens are the effective therapeutic methods for lens luxation of Marfan＇s syndrome. The treatment for the patients with different lens dislocation range should be different.