无晶状体眼屈光矫治方法的概述

Review on the refractive treatment methods of aphakia

无晶状体眼的屈光矫治方法包括框架眼镜矫正、角膜接触镜矫正和人工晶状体(IOL)植入术。框架眼镜矫正物像放大率高,视野受限,婴幼儿无晶状体眼因眼球尚处在发育阶段致无法植入人工晶状体而多选用框架眼镜矫正。角膜接触镜物像放大率低,分为软性角膜接触镜和硬性角膜接触镜,前者因透氧性差易致眼表病变故应用较少,后者透氧性强,尤适合于眼外伤所致不规则散光者或虹膜缺失者。目前临床上最常用的还是人工晶状体植入术,植入人工晶状体的眼更符合生理解剖结构,可以尽量避免屈光参差、像差等不足。根据人工晶状体的植入位置共分为前房型人工晶状体植入术和后房型人工晶状体植入术,前房型人工晶状体植入术又分为房角固定型人工晶状体植入术和虹膜固定型人工晶状体植入术,后房型人工晶状体植入术分为Ⅱ期囊袋内人工晶状体植入术、睫状沟人工晶状体植入术和经巩膜缝线式人工晶状体植入术。

The refractive treatment methods of aphakia include corrective glasses, contact lens correction and intreocular lens （IOL） implantation. It magnifies images highly and limits vision field with corrective glasses. For infant aphakia corrective glasses are more likely to be chosen because their eyes are still unable to tolerate IOL implantation in the developmental stage. With low magnification of images, contact lens includes soft contact lens and rigid contact lens. The former is rarely used because it is prone to ocular lesions due to its poor oxygen permeability. The latter is widely used due to its good oxygen permeability especially suitable for the eyes of irregular astigmatism or iris missing due to trauma. At present, the most commonly used in clinical work is IOL implantation. The eye of IOL may avoid anisometropia, aberrations and so on because of more physiological anatomy. According to the IOL implantation site, it is divided into the anterior chamber IOL implantation and the posterior chamber IOL implantation. The anterior chamber IOL implantation is divided into angle fixed IOL implantation and iris fixed IOL implantation. The posterior chamber IOL implantation is divided into secondary in-the -bag IOL implantation, the ciliary sulcus IOL implantation and transscleral suture fixed IOL implantation.