脱位人工晶状体的手术处理

The surgical management of the dislocated intraocular lens

目的 探讨人工晶状体脱位的原因和处理方法。方法 对 18例 18眼人工晶状体脱位的原因进行分析 ;采用单纯复位、更换和取出人工晶状体的方法进行处理。结果 手术中后囊膜破裂、悬韧带离断和玻璃体脱出是人工晶状体脱位的主要原因。 18眼中 12眼单纯复位成功 ,获得稳定的睫状沟固定 ;4眼更换前房型人工晶状体 ;1眼行睫状沟缝合固定 ;1眼取出人工晶状体后未再植入。随访 1 5个月至 3年 ,除 1眼无晶状体眼外 ,术后矫正视力均≥ 0 1;其中≥0 5者 8眼 ,无严重并发症发生。结论 人工晶状体脱位与术中后囊膜破裂、悬韧带离断、玻璃体处理不当有关。前玻璃体切割单纯取出重新复位 ,是处理人工晶状体脱位简单有效的方法。

ObjectiveTo study the causes and managements of the intraocular lens(IOL) dislocation into vitreous cavity.MethodsThe causes and managements of IOL dislocation in 18 eyes were analyzed.The managements included replacement, reimplantation and removement of IOLs. ResultsThe rupture of posterior capsule , broken ciliary zonule and prolapse of vitreous during surgery were mainly causes of IOL dislocation.Simple replace of the IOL was performed succesfully on 12 of 18 eyes, anterior IOLs were implanted on 4 eyes, ciliary sulcus fixed on 1 eye, and the IOL was removed on 1 eye.Visual acuity was improved 0 1 to 0 8 in 17 eyes, and visual acuity of 8 eyes were≥0 5.ConclusionThe dislocation of the IOL were related to the rupture of posterior capsule , broken ciliary zonule and prolapse of vitreous during surgery.To replace the IOL directly is simple and effective method for management of the IOL dislocation.