超声生物显微镜观察囊袋张力环应用后人工晶状体的偏心量和倾斜度

Decentration and tilt of IOL after capsule tension ring implantation observed by ultrasonic biomicroscope

目的利用超声生物显微镜观察高度近视白内障患者超声乳化吸出联合人工晶状体植入术后囊袋张力环对人工晶状体倾斜度和偏心量的影响。方法选取接受白内障超声乳化吸出联合人工晶状体植入术的高度近视白内障患者36例(40眼),平均眼轴长度26.88 mm。按照术中是否植入囊袋张力环分为植入组和对照组。植入组19眼术中植入囊袋张力环,对照组21眼行常规手术。对患者行常规裂隙灯检查,记录术前、术后6个月最佳矫正视力,并于术后6个月行超声生物显微镜检查得到水平和垂直方向的倾斜度、偏心量,计算人工晶状体总的倾斜度和偏心量。结果两组术后最佳矫正视力均比术前有所提高;术前术后两组间最佳矫正视力比较,差异均无统计学意义(均为P>0.05)。植入组在水平方向、垂直方向以及总的偏心量分别为(0.15±0.07)mm、(0.30±0.40)mm、(0.11±0.02)mm,在水平方向、垂直方向以及总的倾斜度分别为0.02°±0.11°、0.70°±0.25°、0.21°±0.74°。对照组在水平方向、垂直方向以及总的偏心量分别为(0.26±0.19)mm、(0.32±0.60)mm、(0.24±0.97)mm,在水平方向、垂直方向以及总的倾斜度分别为0.11°±0.31°、1.09°±0.20°、1.24°±0.97°。两组人工晶状体水平方向的偏心量和倾斜度,垂直方向的倾斜度及总的偏心量和倾斜度差异均有统计学意义(均为P<0.01);在垂直方向上偏心量差异无统计学意义(P>0.05)。结论囊袋张力环对于白内障合并高度近视患者术后人工晶状体的位置具有稳定作用。

Objective To discuss the effects of capsular tension ring after phaco- emulsification combined with IOL implantation on tilt and decentration of IOL in high myopia patients with cataract by ultrasonic biomicroscope （UBM）. Methods A total of 36 cases （40 eyes） with high myopia and cataract underwent phacoemulsification combined with IOL implantation were chosen. The average axial length was 26.88 nun. The patients were divided into implant group （ 19 eyes, the capsular tension ring was im- planted） and control group （21 eyes, the routine surgery was performed）. The patients were exantined by conventional slit lamp,and the best corrected visual acuity （BCVA） was measured at pre-operation and postoperative 6 months. Tilt and decentration were measured horizontally and vertically, and total tilt and decentration were calculated by geometry method. Results The postoperative BCVA in the two groups were all better than the pre-operation,there was no statistical difference in the preoperative and post- operative BCVA between two groups （ all P 〉 0.05 ）. The horizontal, vertical and total decentration the implant group were （ 0. 15 ± 0.07 ） mm, （ 0. 30 ± 0.40 ） mm, （ 0. 11 ± 0.02） ram,respectively, which in the control group were （0.26 ± 0. 19 ）mm, （0.32± 0. 60） nml, （ 0.24 ± 0.97 ） mm, respectively. The horizontal, vertical and total tilt in the implant group were 0.02° ± 0. 11 ° ,0.70°± 0.25° ,0.21° ± 0.74°, respectively, which in the control group were 0. 11° ± 0.31°, 1.09° ± 0.20°,1. 24 °± 0.97° , respectively. There were statistical differences in the horizontal, total tilt and decentration between two groups （ all P 〈 0.05 ）, but no statistical difference in the vertical tilt and decentration （P 〉 0. 05）. Conclusion The capsular tension ring can stable the IOL position after surgery in high myopia and cataract patients.