人工晶状体囊袋复合体脱位的治疗

Treatment of IOL-capsular complex dislocation

目的评估虹膜夹型人工晶状体置换脱位的人工晶状体囊袋复合体的效果.方法回顾性系列病例研究.分析该院2015年4月至2018年1月人工晶状体囊袋复合体脱位置换术中植入Artisan虹膜夹型人工晶状体8例(8只眼)的临床资料.结果术后经过6~18个月的随访,裸眼视力(LogMAR)为0.34±0.11较术前的1.09±0.56提高(t=3.989,P=0.005);BCVA(LogMAR)为0.18±0.10较术前的0.29±0.12提高(f=3.913,P=0.007).术前和术后眼压分别为(12.60±1.87)mmHg和(10.31±4.67)mmHg(1 mmHg=0.133 kPa),差异无统计学意义(t=1.706,P=0.132).角膜内皮细胞密度由术前的(2411.13±404.44)个/mm2,降至术后的(2161.25±358.95)个/mm2(t=4.686,P=0.002).术前与术后黄斑中心区厚度分别为(197.63±32.04)μm和(205.13±30.44)μm,差异无显著统计学意义(t=-1.974,P=0.089).结论采用Artisan IOL置换脱位的人工晶状体囊袋复合体是一种有效且安全的手术方法.

Objective To evaluate the efficacy of IOL exchange with iris-claw IOL(Artisan)for intraocular IOL-capsule complex dislocation.Methods Retrospective case series.The data of 8 eyes of 8 cases of IOL-capsule dislocation accepted IOL exchange with Artisan IOL from Apr.2015 to Jan.2018 in this hospital were analyzed.Results The followed-up time was 6-18 months.Postoperative UCVA(LogMAR)was significantly ameliorated from 1.09±0.56 to 0.34±0.11(t=3.989,P=0.005).Postoperative BCVA(LogMAR)was also significantly ameliorated from 0.29±0.12 to 0.18±0.10(t=3.913,P=0.007).There was no significant difference in intraocular pressure(t=1.706,P=0.132)between before and after surgery[(12.60±1.87)mmHg v.s.(10.31±4.67)mmHg(1 mmHg=0.133 kPa)].Mean postoperative endothelial cell density(ECD)was(2161.25±358.95)/mm2,preoperative ECD was(2411.13±404.44)/mm2,and the difference was statistically significant(t=4.686,P=0.002).There was no significant difference in central macular thickness(CMT)(t=-1.974,P=0.089)between before and after surgery[(197.63±32.04)μm v.s.(205.13±30.44)μm].Conclusion Artisan IOL for the treatment of IOL-capsule complex dislocation is an effective and safe surgical procedure.