透明角膜隧道切口的二期人工晶状体缝线固定术临床效果评价

A comparative study of clear corneal incision versus superior scleral tunnel incision in secondary intraocular lens implantation

目的:评估和比较透明角膜隧道小切口的二期人工晶状体缝线固定术与传统角巩缘大切口二期人工晶状体缝线固定术的临床疗效。方法:回顾性分析自2009年1月至2015年6月间在丽水市中心医院无晶体眼行透明角膜隧道小切口的二期人工晶状体缝线固定术(A组)40例40眼,选择同时期无晶体眼行传统角巩缘大切口二期人工晶状体缝线固定术41例41眼作对照组(B组),分析2组术后1 d、1周、1个月、3个月裸眼视力及手术源性散光、前房出血、角膜水肿、人工晶状体偏斜等并发症的发生情况。结果:A组和B组比较,各时间点术后裸眼视力和手术源性散光差异均有统计学意义(均P<0.05)。A组前房出血、角膜水肿、人工晶状体偏斜等并发症的发生率均低于B组,2组角膜水肿的发生率差异有统计学意义(P<0.05)。结论:经透明角膜小切口的二期人工晶状体巩膜缝线固定术,对于无晶体眼患者术后裸眼视力的提高,以及手术并发症发生率的降低均有积极的促进作用,是后房型人工晶状体植入的重要补充。

Objective： To evaluate and compare the efficacy between clear corneal small incision and Superior Scleral Tunnel Incision in patients undergoing secondary intraocular lens implantation with suture fixa- tion. Methods： Retrospectively analyzed, 40 aphakic patients performed clear corneal small incision treatment （Group A; 40 eyes） and 41 aphakic patients who underwent traditional corneoscleral incision surgery （Group B; 41 eyes） in Lishui Central Hosptial from 2009 January to 2015 June. Analyzed postoperative complications ineluding visual acuity, surgically-induced astigmatism, hyphema, corneal edema and intraocular lens deflection at 1 day, 1 week, 1 month and 3 months, after surgery. Results： Camparted A and B groups, the difference of visual acuity and surgically-induced astigmatism, in different time after surgery was statistically significant （P〈0.05）, The incidence rate of hyphema, corneal edema and intraocular lens deflection from Group-A was less than Group B, and the difference of incidence rate of corneal edema was statistically significant （P〈0.05）. Conclusion： The secondary intraocular lens suture through tunnel incision on the temporal clear cornea plays a positive role to enhance the postoperative uncorrected visual acuity and decrease complications for patients of aphakia, which is important supplement of posterior chamber intraocular lens.