人工晶体单襻缝线固定治疗晶状体半脱位的临床效果

Clinical effect of single-haptic suture fixation of intraocular lens in the treatment of lens subluxation

目的探讨保留晶状体囊袋人工晶体(IOL)单襻缝线固定治疗晶状体半脱位的安全性和有效性。方法选择2014年1月至2016年11月收治的21例(22眼)晶状体半脱位患者,其中男17例(17眼),女4例(5眼);年龄16~62岁,平均(45.54±12.44)岁。保留晶状体半脱位眼晶状体囊袋,IOL一襻植入悬韧带正常结构侧睫状沟,另一襻经巩膜缝线固定在晶状体脱位侧。术后随访6个月,比较患者术前、术后最佳矫正视力(BCVA)、眼压和IOL位置。结果所有患者手术均顺利完成,有1例(1眼)术后1 d发现前部玻璃体线状积血,经药物保守治疗5 d后吸收;术后6个月检查,患者的术眼眼压为(16.13±2.12)mm Hg,明显低于术前眼压(18.36±2.30)mm Hg(P<0.01);患者的BCVA(0.42±0.17)Log MAR,明显高于术前BCVA(0.08±0.06)Log MAR(P<0.01);且术眼IOL位置居中,未发现倾斜、脱位改变。结论保留晶状体囊袋的IOL单襻缝线固定术治疗晶状体半脱位,能够减少手术创伤,手术方式安全可靠,值得临床推广应用。

Objective To explore the safety and efficacy of single -haptic suture fixation of intraocular lens （IOL）retaining lens capsule in the treatment of lens subluxation. Methods From January 2014 to November 2016, 21 patients（22 eyes） with lens subluxation were selected, including 17 males （17 eyes） and4 females （5 eyes）, aged from 16 to 62years, with an average age of （45.54±12.44）. Retaining lens capsule of the eyes with lens subluxation, one loop of IOLwas implanted in the ciliary groove of the normal structure side of the suspension ligament, and the other loop was fixedin the dislocation side of the lens by scleral suture. Following up for 6 months, the postoperative best corrected visualacuity （BCVA）, intraocular pressure and location of IOL of the patients were compared before and after operation. ResultsAll operations of the patients were successfully completed. There was1 patient （1 eye） found anterior vitreous hemorrhageat 1d after operation and absorbed after 5d of conservative treatment of drugs. By examination at 6 months afteroperation, the intraocular pressure of the patients was （16.13±2.12） mmHg, which was significantly lower than （18.36±2.30） mmHg of the preoperative intraocular pressure （P〈0.01）. The BCVA of the patients was （0.42±0.17） Log MAR,which was significantly higher than （0.08±0.06） Log MAR of the preoperative BCVA（P〈0.01）. The location of IOL in thepatients was in the center and no inclination or dislocation was found. Conclusion Single-haptic suture fixation of IOLretaining lens capsule in the treatment of lens subluxation can reduce surgical trauma, which is safe and reliable andworthy of clinical promotion and application.