YAMANE式巩膜层间无缝线固定术治疗晶状体脱位临床效果的回顾性分析

Retrospective Analysis of the Clinical Effect of YAMANE Scleral Suture for Lens Dislocation

目的:回顾性分析YAMANE式巩膜层间无缝线固定术治疗晶状体脱位的临床效果。方法:选取我院2020年7月—2022年7月间收治的晶状体脱位患者81例,按照随机数字表法分成两组,对照组40例(40眼)采用常规经巩膜缝线固定人工晶状体术治疗,研究组41例(41眼)采用23G微创玻切联合三片式折叠人工晶体YAMANE式巩膜层间无缝线固定术治疗,对比两组患者术后视力恢复及并发症情况。结果:术后1周、3个月时两组患者UCVA、BCVA均较治疗前明显改善(P<0.05),且研究组UCVA、BCVA均高于对照组(P<0.05)。术前两组患者患眼TBUT、中央角膜知觉评分及OSDI评分比较差异无统计学意义(P>0.05),术后3个月时研究组患者TBUT、中央角膜知觉评降幅低于对照组(P<0.05),两组患者OSDI评分增幅比较差异无统计学意义(P>0.05)。相较于术前,术后3个月时角膜内皮细胞计数显著下降,中央角膜厚度明显增加(P<0.05),且研究组中央角膜厚度明显高于对照组(P<0.05)。两组患者术后随访3个月,均无人工晶状体偏位/倾斜情况。研究组并发症发生率略低于对照组,但差异无统计学意义(P>0.05)。研究组耗时显著久于对照组(P<0.05)。结论:23G玻切联合三片式折叠人工晶体YAMANE式巩膜层间无缝线固定术治疗晶状体脱位可更好提升患者的视力,促进眼表功能及生理结构的恢复,安全性较高,值得推广。

Objective:To retrospective analysis of the clinical effect of YAMANE type scleral suture without fixation for lens dislocation.Methods:From July 2020 to July 2022,the lens dislocation patients 81 cases were selected into the research,and were divided into two groups according to the random number table method,for which control group 40 cases(40 eyes)using conventional scleral suture fixation intraocular lens treatment,and study group 41 cases(41 eyes)using 23G glass combined three-piece folding lens YAMANE scleral layers without suture fixation treatment,comparing the two groups of patients postoperative vision recovery and complications.Results:Compared with before treatment,UCVA and BCVA were significantly improved at 1 week and 3 months after operation(P<0.05).Two indexes in the study group were higher than those in the control group at 1 week and 3 months after surgery(P<0.05).There was no significant difference in TBUT,central corneal perception score and OSDI score between the two groups before surgery(P>0.05).3 months after surgery,TBUT and central corneal perception scores in the study group were lower than those in the control group(P<0.05),and there was no significant difference in the increase of OSDI scores between the two groups(P>0.05).The corneal endothelial cell count was significantly decreased and the central corneal thickness was significantly increased 3 months after operation(P<0.05),and the central corneal thickness of the study group was significantly higher than that of the control group(P<0.05).The patients in both groups were followed up for 3 months after surgery,and there was no deviation/tilt of IOL.The complication rate of the study group was slightly lower than that of the control group,but the difference was not statistically significant(P>0.05).The study group spent significantly longer than the control group,and the difference was significant(P<0.05).Conclusion:23G glass incision combined with YAMANE-style interscleral suchless fixation in the treatment of lens dislocation can better improve the visual acuity of patients and promote the recovery of ocular surface function and physiological structure.It is safe and worthy of promotion.