四点固定后房型人工晶体悬吊植入术在白内障手术中的治疗观察

Therapeutic Observation of Four-point Fixed Posterior Chamber Intraocular Lens Suspension Implantation in Cataract Surgery

目的探讨在白内障手术中采用四点固定法后房型人工晶体睫状沟悬吊术的临床有效性和安全性。方法以18例(18眼)无法实施传统后房型人工晶体植入的患者为临床研究对象,采取人工晶体悬吊术,做2、8点位“L”形巩膜瓣,四点法固定人工晶体于睫状沟,术后随访3个月观察术后并发症及视力、验光、眼压等情况。结果18例(18眼)患者手术过程顺利,术后出现黄斑囊样水肿1例、前房积血3例、前房炎性渗出3例、脉络膜脱离2例、一过性眼压升高者6例,经治疗均好转或消退,无明显人工晶体偏位、缝线外露、角膜失代偿等情况。患者术后矫正视力0.1者1例,0.2~0.5者3例,0,6~0.8者10例,1.0者4例,视力均有不同程度提升;角膜散光度平均为(0.89±0.46)D。结论采用四点固定法的后房型人工晶体悬吊术手术效果确切,术后恢复时间缩短,提高了患者术后视觉质量,故值得临床推广应用。

Objective To investigate the clinical efficacy and safety of four-point fixation for posterior chamber intraocular lens ciliary sulcus suspension in cataract surgery.Methods Totally 18 patients(18 eyes)who could not be implanted with the traditional posterior chamber intraocular lens were taken as the clinical research objects.The intraocular lens were suspended and the L-shaped scleral flap was made at 2 or 8 points.The intraocular lens were fixed at the ciliary sulcus by four points.The postoperative complications and visual acuity,optometry,intraocular pressure were observed after 3 months of follow-up.Results Patients of 18 cases(18 eyes)were operated successfully.There were 1 case of cystoid macular edema,3 cases of hyphema,3 cases of inflammatory exudation of anterior chamber,2 cases of choroidal detachment,6 cases of transient intraocular pressure rise.After treatment,they all improved or subsided without obvious intraocular lens deviation,suture exposure,angular membrane decompensation,etc.The postoperative corrected visual acuity was 0.1 in 1 case,0.2 to 0.5 in 3 cases,0,6 to 0.8 in 10 cases,1.0 in 4 cases,and the average corneal astigmatism was(0.89±0.46)D.Conclusion The posterior chamber intraocular lens suspension with four-point fixation is effective,the postoperative recovery time is shortened,and the visual quality of the patients is improved,so it is worth popularizing and applying in clinic.