人工晶状体睫状沟缝线固定联合瞳孔成形术

Ciliary sulcus suture fixation of intraocular lens combined with coreoplasty

目的 观察人工晶状体睫状沟缝线固定联合Siepser滑结缝线法瞳孔成形术处理复杂的眼前段外伤的临床效果.方法 回顾性分析复杂的眼前段外伤35例（35眼）,行人工晶状体睫状沟缝线固定联合Siepser滑结法虹膜缝合及前部玻璃体切除术.随访3月,评估手术效果.结果 35眼术后视力均有不同程度提高,术后3月平均裸眼视力从术前的（0.04 ±0.02）提高到（0.39±0.18）（t=-11.4,P＜0.01）;术后3月平均瞳孔直径从术前的（6.23±2.01） mm缩小至（3.35±0.71） mm（=7.99,P＜0.01）;术后2眼眼压出现一过性升高,经降眼压治疗后恢复正常;所有术眼随访过程中均未出现虹膜前、后粘连或瞳孔膜闭等改变,术后35眼瞳孔均呈圆形或类圆形;无一例出现单眼复视症状;术后角膜内皮细胞数目均无明显下降;畏光和眩光等症状明显减轻或消失.结论 人工晶状体睫状沟缝线固定联合瞳孔成形术在复杂的眼前段外伤处理中是一种安全有效的手术方法.

Objective To observe the clinical efficacy of ciliary sulcus suture fixation of intraocular lens combined with Siepser slipknot suture coreoplasty for complex anterior segment trauma.Methods Thirty five eyes of 35 cases with complex anterior segment trauma,treated with ciliary sulcus suture fixation of intraocular lens combined with Siepser slipknot suture coreoplasty and anterior vitrectomy were analyzed.The follow-up time was 3 months.The surgical effects were analysed.Results Postoperatively,visual acuity was improved in all 35 eyes.After 3 months of operation,the average visual acuity was improved from preoperative （0.04 ±0.02） to postoperative （0.39 ± 0.18） （t =-11.4,P 〈0.01） and the average pupil diameter was reduced from preoperative （6.23 ± 2.01）mm to postoperative （3.35 ± 0.71） mm （t =7.99,P 〈 0.01）.Two eyes had higher intraocular pressure which recovered soon after pressurelowering treatment.During the follow-up period,anterior or posterior synechia or occlusio pupillae was not found in all the eyes.Pupils in 35 eyes were round or nearly round in shape with no complaint of diplopia reported.There was no significant loss in corneal endothelial cell density and photophobia and dazzling sensation was reduced or disappeared after surgery.Conclusion Ciliary sulcus suture fixation of intraocular lens combined with Siepser slipknot suture for coreoplasty is effective and safe for complex anterior segment trauma.