缝线固定带虹膜隔后房型人工晶状体植入术临床观察

Clinical observation of suture fixation with iris black diaphragm IOL implantation

目的 :探讨治疗虹膜缺损无晶状体眼和伴虹膜缺损外伤性白内障的有效方法。方法 :对因手术或外伤致虹膜缺损的 18例 ( 18只眼 )无晶状体眼和 9例 ( 9只眼 )虹膜缺损外伤性白内障患者 ,施行缝线固定带虹膜隔后房型人工晶状体手术。结果 :术后随访 4～ 15个月 ,平均 8 5个月。与术前相比 ,术后视力提高 ,具有显著性差异 (P <0 0 1) ;2 6只眼畏光症状消失 ,1只眼仍轻度畏光。术后眼压增高 ( >2 1mmHg)者 3只眼 ,其中 2只眼为玻璃体切割术后眼 ,经局部用药眼压降至正常范围。所有病例人工晶状体均无偏位 ,均未发生睫状体出血和视网膜脱离。结论 :缝线固定带虹膜隔后房型人工晶状体手术是治疗虹膜缺损无晶状体眼和伴虹膜缺损外伤性白内障的有效方法 ,但其价格昂贵 ,且术后葡萄膜反应重 ,应严格掌握适应证。

Objective:To investigate the clinical therapeutic effects of suture fixation with iris black diaphragm IOL implantation for patients with aphakia and traumatic cataract with iridocoloboma.Methods:Iris black diaphragm IOL implantations were fixated in 27patients(27eyes)with suture.Of these patients,18(18eyes)had postoperative or traumatic aphakia and iridocoloboma and 9(9eyes)had traumatic cataract and aniridia.Results:These patients were followed up for 4～15 months(average 8 5 months).The postoperative vision was significantly better than the preoperative vision(P<0 01).One patient(1 eye)still feeled slight photophobia.In 3 eyes the IOP increased to higher than 21mmHg,of these 2 eyes had been underwent vitrectomy,the IOP decreased to normal range after administration of topical antiglaucoma drug.There was no dislocation of IOL in all cases,and no occurrence of ciliary body bleeding or retinal detachment.Conclusion:Suture fixation with iris black diaphragm IOL implantation is an effective method for the treatment of iridocoloboma and traumatic cataract with iridocoloboma,but as the IOL is expensive and postoperative uveal inflammatory reaction is serious,patient should be selected cautiously.