眼外伤晶体玻璃体切割术后二期人工晶体悬吊术的临床分析

Clinical analysis of secondary intraocular lens suture fixation after ocular trauma lens-vitrectomy

目的分析二期后房型人工晶体悬吊术对于治疗眼外伤术后无晶体眼的临床疗效。方法回顾性分析2014年5月至2018年1月因眼外伤已行一期晶状体玻璃体切割术的无晶体眼患者(31例31眼)再次入院行二期人工晶体悬吊术的临床资料,分析患者术后视力恢复情况,观察其并发症的发生。结果 31例患者,术前最佳矫正视力为0.322±0.250,术后最佳矫正视力0.465±0.258,与术前相比明显提高(t=-3.286,P=0.003)。术后角膜水肿15例,反应性虹睫炎7例,眼压升高5例,低眼压2例,前房或玻璃体出血3例,人工晶体偏位1例,无眼内感染、驱逐性出血、视网膜脱离、角膜内皮失代偿等严重并发症。结论二期后房型人工晶体巩膜悬吊术在眼外伤无晶体眼患者中疗效显著,术后并发症较少,是一期晶状体玻璃体切割术后首选的矫正视力方式。

Objective To analyze the clinical effect of secondary posterior chamber intraocular lens(IOL)suture fixation in the treatment of aphakia after ocular trauma surgery.Methods A retrospective analysis was performed on 31 cases(31 eyes)with ocular trauma who underwent vitreous lens cutting and received secondary posterior chamber intraocular lens implantation with suture fixation during May 2014 to January 2018.Postoperative visual acuity of these patients were analyzed and the complications were observed.Results Among the 31 patients,preoperative optimal-corrected visual acuity was 0.322±0.250,and the best-corrected visual acuity after surgery was 0.465±0.258,which was significantly better than that before surgery(t=-3.286,P=0.003).After surgery,corneal edema occurred in 15 cases,reactive iridocyclitis in 7 cases,elevated intraocular pressure in 5 cases,low intraocular pressure in 2 cases,anterior chamber or vitreous hemorrhage in 3 cases,IOL deviation in 1 case.No serious complications such as intraocular infection,expel hemorrhages,retinal detachment,corneal endothelial decompensation occurred.Conclusion The secondary posterior chamber IOL suture fixation is the preferred way to improve visual acuity after primary lens vitrectomy as it is effective in aphakia caused by ocular trauma and postoperative complications are rare.