新式无线结巩膜层间Z字缝合法在人工晶状体悬吊术中的应用分析

Applied analysis of new knotless technique for scleral interlaminar Z-suture in intraocular lens suspension

目的探讨新式无线结巩膜层间Z字缝合法悬吊人工晶状体(IOL)的手术方式及其安全性。方法分析27例(30眼)行无线结巩膜层间Z字缝合法悬吊IOL患者的临床资料,记录术前、术后最佳矫正视力(BCVA)、眼压、术后超声生物显微镜(UBM)、IOL位置等,探讨此手术方式并分析其安全性。结果术前BCVA与术后一周BCVA、术后一周BCVA与术后一月BCVA,差异均无统计学意义(P>0.05)。术中1眼发生脉络膜上腔出血(SCH),2周后手术干预,术后视力恢复良好。术后2眼眼压升高、3眼出现角膜水肿,一周内均恢复正常。术后1月进行UBM检查,IOL位置居中。术后平均随访时间11.35月,未发现IOL脱位、眼内炎等。结论新式无线结巩膜层间Z字缝合法悬吊IOL手术操作方式简单,术后并发症少,恢复时间短,视力恢复佳;该术式可以作为治疗无后囊支撑或悬韧带异常患者的一种选择。

Objective To investigate the operation mode and safety of new knotless scleral interlaminar Z-suture in intraocular lens suspension(IOL).Methods Clinical data of 27 patients(30 eyes)who underwent surgery of IOL with knotless scleral interlaminar Z-suture were analyzed.The preoperative BCVA,postoperative BCVA,intraocular pressure,postoperative UBM,and IOL location were recorded and the operation mode and safety were analyzed.Results There was no statistically significant difference when preoperative BCVA was compared to BCVA one week after surgery and when postoperative BCVA one week after surgery was compared to BCVA one month after surgery(P>0.05).There was one eye with intraoperative suprachoroidal hemorrhage(SCH).A surgery was performed on this eye after 2 weeks and its visual acuity was recovered.There were 2 eyes with transient elevated intraocular pressure and3 eyes with mild corneal edema after surgery,and all of them returned to normal within one week.UBM examination was conducted one month after the operation,and the IOL position was centered.The mean follow-up time was 11.35 months,and there were no IOL dislocation and endophthalmitis.Conclusion The technique of new knotless trans-scleral Z-suture in IOL is simple with fewer postoperative complications,shorter recovery time and better visual recovery.It is a relatively good choice when patients are without posterior capsule or their zonnlar fibersis is abnormal.