23G玻璃体切割联合Ⅰ期人工晶状体睫状沟悬吊术治疗晶状体脱位

23G vitrectomy combined with primary ciliary sulcus fixation of IOL implantation for the treatment of lens dislocation

目的探讨23G玻璃体切割联合Ⅰ期人工晶状体睫状沟悬吊术治疗晶状体脱位的临床效果。方法回顾性分析我院诊治的29例晶状体全脱位于玻璃体腔行手术治疗的病例资料,术前矫正视力≥0.06,瞳孔<5 mm。根据手术方式分为2组,其中23G玻璃体切割术后58~122 d(平均76d),行Ⅱ期人工晶状体睫状沟悬吊术者14只眼,为A组;23G玻璃体切割术联合Ⅰ期人工晶状体睫状沟悬吊术者15只眼,为B组,两组患者均通过3.0 mm透明角膜切口植入折叠人工晶状体,缝合固定于睫状沟。比较两组术后视力,术中、术后并发症。结果所有患者术后视力均有不同程度提高,两组人工晶状体睫状沟悬吊术后1、6个月裸眼及最佳矫正视力比较差异无统计学意义(P>0.05),术后12个月人工晶状体居中性良好,未见偏位或倾斜及其他并发症。结论23G玻璃体切割联合Ⅰ期人工晶状体睫状沟悬吊术治疗晶状体全脱位,未增加手术并发症,且避免了二次手术可能的风险,可有效改善患者术后视力。

Objective To investigate the clinical effects of 23G vitrectomy for the treatment of lens dislocation combined with primary ciliary sulcus fixation of IOL implantation.Methods A retrospective analysis on 29 confirmed cases of dislocation of lens who underwent surgeries in ophthalmology department of our hospital,and all the patients were found that the lenses dislocated into vitreous cavity.Fourteen cases who underwent secondary surgery 58~122days(76 days on average)after 23G vitrectomy were devided into group A and 15 cases who underwent combined surgery were devided into group B.Patients in both groups underwent foldable IOL implantation by ciliary sulcus suture fixation through a 3.0 mm clear corneal incision.The postoperative visual acuity,intraoperative,early postoperative and long-term complications in the 2 groups were compared.Results The postoperative visual acuity was improved in all the cases of 2 groups;there were no significant differences in the uncorrected visual acuity and best corrected visual acuity(BCVA)between groups at 1 month and 6 month after IOL ciliary sulcus fixation surgery.There was no IOL decentration or tilting or other complications in two groups at 12 month.Conclusions 23G vitrectomy for the treatment of lens dislocation combined with primary ciliary sulcus fixation of IOL implantation can effectively improve the patient's postoperative visual acuity,doesn’t increasing surgical complications and avoid the trauma and the potential risks of secondary surgery.