【摘要】：目的探討應(yīng)用前段玻璃體切割、囊袋拉鉤聯(lián)合Cionni改良張力環(huán)(Cionni-modified capsular tension ring,MCTR)在伴有前房玻璃體脫出的外傷性晶狀體半脫位手術(shù)中的有效性和安全性。方法伴有前房玻璃體脫出的外傷性晶狀體半脫位患者16例(16眼),脫位范圍在90°~120°7眼、120°~180°5眼、180°~270°4眼,其中合并虹膜根部離斷3眼、express植入1眼、青光眼瓣膜閥植入1眼。根據(jù)前房玻璃體情況,行曲安奈德染色后經(jīng)前房或睫狀體平坦部行玻璃體切割術(shù),連續(xù)環(huán)形撕囊后使用2~4個囊袋拉鉤鉤住撕囊邊緣,穩(wěn)定晶狀體囊袋并使其居中,超聲乳化白內(nèi)障吸出、MCTR植入及鞏膜層間縫合固定,晶狀體囊袋內(nèi)植入折疊人工晶狀體(intraocular lens,IOL)。術(shù)后隨訪3個月,觀察術(shù)后視力、術(shù)中術(shù)后并發(fā)癥、前囊口、IOL位置、眼壓情況。結(jié)果所有患者均順利完成白內(nèi)障吸出、MCTR及IOL植入;其中植入雙鉤MCTR 7眼,單鉤9眼。術(shù)后視力0.5者9眼,0.3~0.5者4眼,0.1~0.3者2眼,≤0.1者1眼,術(shù)后術(shù)眼最佳矯正視力與術(shù)前比較,差異有統(tǒng)計學(xué)意義(χ2=17.503,P=0.000)。Pantacam眼前段分析系統(tǒng)獲得Scheimpflug圖像分析IOL居中性好,無MCTR及IOL移位等并發(fā)癥發(fā)生。術(shù)中術(shù)后并發(fā)癥有皮質(zhì)殘留、房水后部返流綜合征、前囊撕裂、前囊口收縮、后囊膜混濁等。結(jié)論有效前房或睫狀體平坦部玻璃體切割是減少手術(shù)并發(fā)癥的關(guān)鍵,前段玻璃體切割、囊袋拉鉤聯(lián)合Cionni張力環(huán)植入是伴有前房玻璃體脫出的外傷性晶狀體不全脫位較理想的術(shù)式選擇。
[Abstract]:Objective to evaluate the efficacy and safety of anterior vitrectomy bag retractor combined with Cionni modified tension loop (Cionni-modified capsular tension ring,MCTR) in traumatic lens subluxation with anterior chamber vitreous prolapse. Methods Sixteen cases (16 eyes) of traumatic lens subluxation with anterior chamber vitreous prolapse were included. The range of dislocation was 90 擄~ 120 擄7 eyes, 120 擄~ 180 擄5 eyes, 180 擄~ 270 擄4 eyes, including 3 eyes with iridotomy, 1 eye with express implantation and 1 eye with glaucoma valve implantation. According to the vitreous condition of anterior chamber, the anterior chamber was stained with triamcinolone acetonide and vitrectomy was performed through the anterior chamber or the flat part of the ciliary body. After continuous circular capsulorhexis, 2 ~ 4 bag retractor was used to hold the edge of the capsular tear, to stabilize and center the lens capsular bag. Phacoemulsification cataract extraction, MCTR implantation and scleral interlaminar suture fixation, intraocular lens (intraocular lens,IOL) implantation in the capsular bag. Postoperative visual acuity, postoperative complications, anterior capsule orifice, IOL location and intraocular pressure were observed after 3 months follow-up. Results all patients successfully completed cataract aspiration, MCTR and IOL implantation, including 7 eyes with double hook MCTR and 9 eyes with single hook. The postoperative visual acuity was 0.5 in 9 eyes, 0.3 in 4 eyes, 0.3 in 2 eyes, and 鈮，

本文編號：2422667