囊袋内及囊袋外人工晶状体不全脱位微创复位术的效果

The efficacy of microinvasive reposition surgery of in-the-bag and out-of-the-bag intraocular lens subluxation

目的:评价囊袋内及囊袋外人工晶状体不全脱位微创复位术的效果。方法:回顾性研究。纳入2015年10月至2020年7月福建省立医院囊袋外人工晶状体不全脱位16例(18眼),囊袋内人工晶状体不全脱位5例(5眼),同期就诊于福建龙岩人民医院囊袋外人工晶状体不全脱位2例(2眼),共23例(25眼)。其中5眼采用外路法人工晶状体襻-囊袋巩膜缝线固定复位术,20眼采用外路法人工晶状体襻巩膜缝线固定复位术。结果:术中2眼出现少量前房积血,术后5~7 d自行吸收,无视网膜脱离、玻璃体积血、爆发性脉络膜上腔出血或眼压升高等术中术后并发症。术后视力0.3~0.4者6眼,≥0.5者5眼,其余9眼因伴有视网膜疾病视力极差,但也有明显提高。术后随访3个月~4年,所有患者的人工晶状体位置居中、稳定。结论:囊袋内及囊袋外人工晶状体不全脱位微创复位术安全有效。

Objective To evaluate the clinical efficacy of microinvasive reposition surgery for the management of in-the-bag and out-of-the-bag intraocular lens(IOL)subluxation.Methods This was a retrospective study.Total of 20 eyes of 18 consecutive patients with out-of-the-bag IOL subluxation,including 18 eyes from Fujian Provincial hospital,2 eyes from Fujian Longyan People’s Hospital,and 5 eyes of 5 consecutive patients with in-the-bag IOL subluxation in Fujian Provincial Hospital from Oct.2015 to Jul.2020 were recruited.Five eyes with in-the-bag IOL subluxation received ab externo transscleral suture fixation and 20 eyes received ab externo scleral suture fixation using temporary externalization of the haptics through a clear corneal incision.Results Hyphema occurred in 2(8.33%)eyes intraoperatively,and resolved after 5-7 days postoperatively.At the last follow-up,no postoperative complication such as elevated intraocular pressure,retinal detachment,vitreous hemorrhage,explosive suprachoroidal hemorrhage occurred.The visual acuity was 0.3-0.4 in 6 eyes and≥0.5 in 5 eyes.Poor visual acuity was observed in 9 eyes accompanied by retinal disorders,yet their visual acuity improved markedly.Conclusion It is a safe and effective microinvasive surgery to reposition the subluxated IOL an IOL-capsule complex.