玻璃体切除术后无晶状体眼Ⅱ期人工晶状体植入术式的临床观察

Clinical observation of intraocular lens implantation in secondary to aphasic eyes vitrectomy

目的探讨复杂性眼外伤或视网膜脱离行玻璃体切除术后无晶状体眼Ⅱ期不同类型人工晶状体植入术式临床疗效,评估手术的可行性。方法对41例(41眼)因复杂性眼外伤或视网膜脱离行玻璃体切除术后无晶状体眼,分别行前房型人工晶状体植入术18眼、后房型人工晶状体缝线固定术17眼、带虹膜人工晶状体植入术后6眼,术后平均随访10月。结果41例患者术后裸眼视力均达到或接近术前矫正视力。其中前房型人工晶状体植入术18眼中最好视力≥0.5者(44％),后房型人工晶状体缝线固定术17眼中最好视力≥0.5者9眼(53％),带虹膜人工晶状体植入术6眼中最好视力≥0.5者2眼(33％)。结论晶状体、玻璃体切除术后人工晶状体植入术式的选择,主要应根据患者的瞳孔大小、眼压、房角结构及患者全身情况选择术式,2种不同类型人工晶状体植入术式临床疗效,经过统计学处理无显著性差异P>0.05,术后的视力与角膜及眼损伤程度及术后散光密切相关。

Aim To study the clinical effect of different kinds of secondary intraocular lens(IOL) implantation in aphasic eyes after vit-rectomy for ocular trauma or retinal detachment and to evaluate the feasibility for the surgical operation. Methods Fourty one cases of aphasic eyes (41 eyes) from previous lensectomy and vitrectomy for ocular trauma or retinal detachment received different kinds of secondary IOL implantation. Anterior chamber IOL implantation was performed on 18 eyes, suture fixation of posterior chamber IOL on 17 eyes and IOL with artificial iris on 6 eyes. The average follow up was 10 months. Results The best visual acuity improved in all the 41 eyes, and was better than 0.1 in most eyes. In the 18 eyes of anterior chamber IOL implantation, 8 gained 0.5 or more visual acuity (44%); in 17 eyes of suture fixation of posterior chamber IOL, 9 gained 0.5 or more(53%); and in 6 eyes of IOL with artificial iris implantation, 2 gained 0.5 or more(33%). Conclusion The manner of IOL implantation in aphasic eyes following lensectomy and vitrectomy should be decided on according to the size and shape of pupils, IOP, condition the angle of anterior chamber, the degree of iris damage. There is no statistic difference(P>0.05) between the 2 different kinds of IOL implantation. The postoperative vision highly depends on the severity of trauma and stigma after operation.