晶状体囊袋张力环在晶状体悬韧带断裂的白内障手术中的应用

Application of capsular tension ring in cataract surgery for zonular dialysis

目的 评价晶状体囊袋张力环 (capsulartensionring ,CTR)在晶状体悬韧带断裂的白内障手术中的应用。方法 对 11例 ( 11只眼 )外伤性晶状体悬韧带部分断裂的患者行白内障手术 ,术中连续环形撕囊后植入CTR ,然后行白内障摘除及后房型人工晶状体囊袋内植入。结果 11只眼的人工晶状体均处于正位 ,无倾斜及明显偏位。术后 1个月矫正视力 0 4者 4只眼、0 5～ 0 8者 5只眼、>0 8者 2只眼。 1只眼因CTR直径过大 ,可见CTR 2个端口重叠。除白内障手术固有的并发症外 ,未见CTR引起其他并发症。结论 对晶状体悬韧带断裂的白内障患者术中应用CTR ,可利于术中操作 ,防止术后人工晶状体偏位的发生 ,并且有助于患者视力恢复 ;CRT是一种有效的白内障手术辅助工具。

Objective To evaluate the application of capsular tension ring (CTR) in the cataract surgery for zonular dialysis. Methods Eleven cases of partially traumatized zonular dialysis patients were managed with CTR after continuous curvilinear capsulorrhexis (CCC), cataract extraction and posterior chamber intraocular lens (IOL) implantation. Results The IOLs in all the eyes were basically in the normal position without tilting or obvious decentration. One month postoperatively, the best-corrected visual acuity (BCVA) was 0.4 in 4 eyes, 0.5～0.8 in 5 eyes and over 0.8 in 2 eyes. A side-by-side overlap of both eyelets of the ring happened in 1 eye due to the bigger diameter of CTR, and no other complications were seen except the original complication of cataract surgery. Conclusions For the patients of zonular dialysis, the CTR can preserve the integrity of the capsular bag, provide the necessary capsular space while giving a counter-traction, reduce asymmetric capsular forces, stabilize the vitreous base, facilitate phacoemulsification, aspiration of cortex and IOL implantation, prevent the postoperative IOL decentration and allow a quicker visual recovery. The CTR is a useful device that effectively supplements the currently available cataract surgery armamentarium, and develops the application of posterior chamber IOL implantation.