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眼前节重建联合以增殖膜为依托的Ⅱ期后房型IOL植入术的疗效 被引量:1

Anterior segment reconstruction and secondary posterior chamber intraocular lens implantation supported by fibromembrane
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摘要 目的:探讨以眼前节结构紊乱重建,联合以增殖膜为依托行Ⅱ期后房型人工晶状体(IOL)植入的手术方法,并评价其疗效。方法:对我院1995-09/2015-10眼球穿通伤致眼前节不同程度结构紊乱并行眼前节结构重建联合Ⅱ期后房型人工晶状体植入术患者(156眼)的资料进行回顾性分析。所行手术包括部分穿透性角膜移植、前粘连松解术、虹膜根部离断缝合术、后粘连松解术、瞳孔成形术、瞳孔区增殖膜造孔术和以增殖膜为依托行Ⅱ期后房型人工晶状体植入术。对术中及术后并发症、视力、眼压、角膜内皮细胞、人工晶状体位置等情况进行观察。随访3~18mo。结果:患者156眼均手术顺利,术后矫正视力≥0.5者123眼(78.8%),其中≥0.8者17眼(10.9%),≤0.4者33眼(21.2%)。术后人工晶状体位置:正位133眼(85.3%),稍偏离中心者23眼(14.7%);术后8眼前房出血,其中6眼经保守治疗痊愈,2眼经原切口吸出前房血膜。5眼角膜斑翳致密,位于角膜中央者行部分穿透性角膜移植,2mo后产生排异反应,经保守治疗痊愈。全部患者术后炎症反应轻微,无严重远期并发症。结论:在重建眼前节结构联合Ⅱ期人工晶状体植入时,在预植入人工晶状体的位置,存在足够的增殖膜可支撑人工晶状体,而无需采用缝线固定的方法,这样可避免因缝线所致的各种并发症发生。 AIM: To evaluate the methods and effects of secondary intraocular lens im plantation based on proliferative m em brane in anterior segm ent reconstruction.METHODS: Totally 156 eyes with penetrating injury had varying degrees of anterior segm ent disorders w hich had secondary intraocular lens im plantation based on proliferative m em brane to anterior segm ent reconstruction. Including partial penetrating keratoplasty,front-adhesion release,iris root suture,post-adhesion release, pupillary plasty, hole m aking in pupil area proliferative m em brane and secondary intraocular lens im plantation based on proliferative m em brane. All patients were followed up 3-18 m o.RESULTS: The surgeries were successful in all patients.The corrected visual acuity of 123 eyes( 78. 8%) were ≥0. 5,17 eyes( 10. 9%) were ≥ 0. 8 and 33 eyes( 21. 2%)were ≤ 0. 4. Postoperative intraocular lens position was133 eyes( 85. 3%),intraocular lens slightly off the center of 23 eyes( 14. 7%). Anterior cham ber hem orrhage occurred in 8 eyes, 6 of them were recovered by conservative treatm ent and the blood m em brane in another 2 eyes were sucked out through prim ary incision,and 5 cases of corneal plaque dense in the center of the cornea are partially penetrating keratoplasty. After 2 m o,a rejection reaction occurs,w hich is cured by conservative treatm ent. All patients had slight postoperative inflam m ation and without severe long-term com plications.CONCLUSION: Reconstruction of the anterior segment of the eye, proliferative m em brane can support the intraocular lens at the pre-im plantation of the intraocular lens,without the need for suture fixation,thus avoiding various com plications due to sutures.
作者 熊蕾 刘子瑶 姚亮 韩娼婧 范雅稚 熊全臣 Lei Xiong;Zi-Yao Liu;Liang Yao;Chang-Jing Han;Ya-Zhi Fan;Quan-Chen Xiong(Department of Ophthalmology,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,Shaanxi Province,China)
出处 《国际眼科杂志》 CAS 北大核心 2019年第4期563-566,共4页 International Eye Science
关键词 眼球穿通伤 外伤性白内障 眼前节重建 增殖膜 人工晶状体 后房型 penetrating injuries to eye traumatic cataract anterior segment reconstruction proliferative membrane intraocular lens posterior chamber
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