可折叠人工晶体单襻悬吊术在处理后囊膜破裂中的效果

Effect of foldable intraocular lens single loop suspension in the treatment of capsular rupture

目的:观察可折叠人工晶体单襻悬吊术在处理白内障超声乳化术中后囊膜破裂的临床应用效果及安全性。方法:回顾性分析2015年1月至2016年12月在南京医科大学附属无锡人民医院行白内障超声乳化术并出现后囊膜破裂的64例(64眼)白内障患者,分为试验组(33例33眼)和对照组。试验组行可折叠人工晶体单襻悬吊术;对照组(31例31眼)行硬片式人工晶体双襻悬吊术。手术当天记录疼痛评分,并分别于术后1d、术后1周及术后1个月记录术眼视力、眼压、前房反应、晶体位置及并发症发生情况。结果:试验组的疼痛反应较对照组显著减轻(P<0.05)。术后第1天,两组视力、眼压、前房反应差异均无统计学意义(P>0.05)。术后1周试验组前房反应较对照组小(P<0.05),两组视力、眼压差异均无统计学意义(P>0.05)。术后1个月两组视力、眼压、前房反应差异均无统计学意义(P>0.05)。试验组中1例(3.03%)术后第1天出现前房积血,2例(6.06%)出现人工晶体轻度偏位;对照组1例患者(3.33%)术后第1天出现一过性眼压增高,未发现其余并发症。结论:改良折叠型人工晶体上方悬吊术是处理白内障超声乳化术中后囊膜破裂安全可行的手术方式。

Objective:To evaluate the safety and effectiveness of foldable intraocular lens single loop suspension in the treatment of posterior capsule rupture in the phacoemulsification.Methods:Sixty-four patients(64 eyes)with posterior capsular rupture during cataract surgery from January 2015 to December 2016 were selected and divided into an experimental group(33 patients,33 eyes)and a control group(31 patients,31 eyes).The experimental group received foldable intraocular lens single loop suspension,and the control group received hard plate intraocular lens suspension.Pain score was recorded on the day of operation;visual acuity,intraocular pressure,anterior chamber response,crystal location and other complications were recorded separately on the day after operation,1 week and 1 month after operation.Results:Patients felt less painful in the experimental group(P<0.05).There was no significant difference in visual acuity,intraocular pressure and anterior chamber response between the two groups the day after operation(P>0.05).But the anterior chamber reaction in the control group was more serious than in the experimental group when observed one week and one month after operation(P<0.05),and there was no significant difference in visual acuity,intraocular pressure and anterior chamber response between the two groups.In the experimental group,1 patient(3.03%)had hyphema,and 2 patients(6.06%)had a slight tilt of the intraocular lens.In the control group,1 patient(3.33%)had transient intraocular hypertension.Conclusion:Foldable intraocular lens single loop suspension is a safe and feasible operation to treat posterior capsular rupture in phacoemulsification.