无虹膜眼人工晶状体植入术

Intraocular lens implantation in aniridia

目的 探讨无虹膜眼人工晶状体植入的手术方法,并评价其疗效。方法 对46例(47眼)无虹膜眼行人工晶状体植入术。其中外伤性白内障42眼,先天性白内障5眼。手术方式:晶状体玻璃体切除人工晶状体睫状沟缝线固定术、囊袋内人工晶状体植入术、带虹膜隔人工晶状体植入术及联合穿透性角膜移植术。随访1-14月,平均4.8月。结果 47眼手术顺利,术后人工晶状体位置正。术后矫正视力≥0.5者33眼(70.21％),0.1-0.4者12眼(25.56％);术后4眼眼压升高,10眼前房纤维蛋白渗出。无严重远期并发症。结论 无虹膜眼人工晶状体植入是可行的,但患者眼部情况复杂,应根据眼部具体情况选择手术方式和人工晶状体的类型。影响术后视力恢复的主要因素是散光。

Objective To evaluate the methods and effects of intraocular lens (IOL) implantation in aniridia. Methods The IOL implantation was performed on 47 eyes of traumatic aniridia (42 eyes) and congenital aniridia(5 eyes),Surgical methods included:vitrectomy-lensectomy with IOL suture fixation, IOL implantation in the capsular bag, black diaphragm IOL implantation, and IOL implantotion combined with penetrating keratoplasty. Results After follow up for 1 ~ 14 months, the IOL correctly centered was in all cases. The postoperative visual acuities were ≥0.5 in 33 eyes(70.21%) ,0.1 -0.4 in 12 eyes (25.56%) .The fibrin exudation was occurred in 10 eyes. IOP elevation was found in 4 eyes. All patients had no severe long term complications. Conclusion The results suggest that the IOL implantation is effective in the management of aniridia, but these cases are complicated, proper selection of indication is the key point of the surgery. The major cause affecting the postoperative VA is astigmatism.