本文選題：虹膜缺如 + 虹膜隔人工晶狀體��； 參考：《青島大學(xué)》2013年博士論文

【摘要】：目的 眼球破裂傷常合并嚴(yán)重的虹膜、晶狀體和玻璃體視網(wǎng)膜的損傷。通過手術(shù)治療,大多數(shù)患者可以恢復(fù)一定的視功能,但是由于虹膜缺損帶來的球面像差和色像差問題,給患者帶來了嚴(yán)重的畏光和眩光癥狀。自從虹膜隔人工晶狀體(black diaphragm intraocular lens, BDI)面世以來,國內(nèi)外學(xué)者先后發(fā)表了多篇關(guān)于植入虹膜隔人工晶狀體的臨床病例報告。多數(shù)學(xué)者認(rèn)為植入虹膜隔人工晶狀體是治療無虹膜無晶狀體患者的有效方法。 我們對在青島眼科醫(yī)院接受虹膜隔人工晶狀體植入的患者進(jìn)行了長期隨訪觀察,發(fā)現(xiàn)部分患者有嚴(yán)重的繼發(fā)性青光眼和角膜內(nèi)皮功能失代償發(fā)生。針對這個問題,我們將植入技術(shù)進(jìn)行了改進(jìn),以避免虹膜隔人工晶狀體植入術(shù)后遠(yuǎn)期并發(fā)癥的發(fā)生。并對使用改進(jìn)技術(shù)的患者進(jìn)行隨訪,報告長期隨訪的結(jié)果。 方法 青島眼科醫(yī)院自1998年9月開始為虹膜缺損、缺如的患者植入虹膜隔人工晶狀體,截止2012年12月共為78例患者的78只眼植入虹膜隔人工晶狀體。1998年9月-2007年8月為第一階段,在這個階段我們?yōu)?3例患者植入了虹膜隔人工晶狀體。2008年11月至2012年12月為第二階段,采用改進(jìn)的植入技術(shù)為25例患者植入了虹膜隔人工晶狀體。我們通過電話、網(wǎng)絡(luò)和家訪等多種途徑聯(lián)系患者,邀請其返院復(fù)診,重點(diǎn)檢查矯正視力,眼壓,角膜內(nèi)皮計數(shù)和超聲生物顯微鏡檢查(UBM)觀察虹膜隔人工晶狀體位置。 結(jié)果 第一階段的53例患者中隨訪到30例,其中18例保持了良好的眼部情況,12例患者發(fā)生角膜內(nèi)皮功能失代償和繼發(fā)性青光眼等并發(fā)癥。接受技術(shù)改進(jìn)的第二階段的25例患者均保持良好的眼部情況,沒有嚴(yán)重并發(fā)癥發(fā)生。 結(jié)論 對于虹膜完全缺如的患者,虹膜隔人工晶狀體植入時懸吊植入的位置適當(dāng)偏后并要做到術(shù)中牢固固定,使之不與角膜內(nèi)皮及房角接觸,以避免該手術(shù)的遠(yuǎn)期并發(fā)癥的發(fā)生。
[Abstract]:Purpose Rupture of the eyeball is often associated with severe iris, lens, and vitreoretinal injuries. Through surgical treatment most patients can recover certain visual function but the spherical aberration and color aberration caused by iris defect bring serious photophobia and glare to the patients. Since the appearance of black diaphragm intraocular lens, BDI) in iris septum intraocular lens (IOL), domestic and foreign scholars have published a number of clinical reports on the implantation of IOL in iris septum. Most scholars believe that the implantation of iris septum intraocular lens is an effective method for the treatment of aphakic patients. A long term follow-up study was carried out on patients receiving iris septum intraocular lens implantation in Qingdao Ophthalmology Hospital. Serious secondary glaucoma and corneal endothelial decompensation were found in some of the patients. To solve this problem, we improved the implantation technique to avoid long-term complications after IOL implantation. Patients using the improved technique were followed up and the results of long-term follow-up were reported. Method Since September 1998, Qingdao Ophthalmology Hospital has been responsible for iris defect. Iris septum IOL was implanted in 78 eyes of 78 patients by December 2012. The first stage was from September 1998 to August 2007, and Iris septum IOL was implanted in 78 eyes from September 1998 to August 2007 in Qingdao Ophthalmology Hospital. At this stage, we implanted iris septum intraocular lens in 53 patients, and in the second stage from November 2008 to December 2012, 25 patients were implanted with iris septum intraocular lens using improved implantation technique. We invite the patients to return to hospital through telephone, network and home visits, and focus on the examination of corrected visual acuity, intraocular pressure, corneal endothelium count and ultrasound biomicroscopy (UBMM) to observe the location of intraocular lens in the iris septum. Result Among the 53 patients in the first stage, 30 cases were followed up. Among them, 18 cases maintained good eye condition and 12 cases developed corneal endothelial decompensation and secondary glaucoma complications. All of the 25 patients undergoing the second stage of the technical improvement maintained a good eye condition without serious complications. Conclusion For the patients with complete iris absence, the position of suspended implantation of iris septum intraocular lens implantation should be properly deviated and fixed firmly during operation so as to avoid the long-term complications of the operation in order to avoid contact with corneal endothelium and angle of atrium.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2013
【分類號】：R779.6

【共引文獻(xiàn)】

相關(guān)期刊論文 前7條

1 吳潔,朱斌良,張長寧,馬挺;穿透性角膜移植聯(lián)合帶虹膜人工晶狀體植入術(shù)3例[J];國際眼科雜志;2004年01期

2 范春生;;虹膜膈人工晶狀體用于治療外傷性白內(nèi)障伴虹膜缺損的臨床觀察[J];國際眼科雜志;2009年12期

3 張慶華;陳鈞;劉瓊;;眼前段多結(jié)構(gòu)損害合并白內(nèi)障的手術(shù)治療[J];廣東醫(yī)學(xué);2012年20期

4 高雪霞;王瑞峰;;虹膜型人工晶狀體在無晶狀體聯(lián)合虹膜缺如眼中的應(yīng)用[J];醫(yī)藥論壇雜志;2011年07期

5 李韻倩;王劍鋒;方麗;;病理性大瞳孔下顯微小撕囊口白內(nèi)障超聲乳化術(shù)臨床研究[J];臨床眼科雜志;2008年02期

6 王敏;羅怡;;二期后房型人工晶狀體縫線固定術(shù)治療晶狀體玻璃體切除術(shù)后無晶狀體眼的臨床觀察[J];臨床眼科雜志;2009年02期

7 鄒文青;徐惠芳;;虹膜型人工晶體植入術(shù)治療外傷性無虹膜眼的療效觀察[J];寧夏醫(yī)學(xué)雜志;2007年10期

相關(guān)碩士學(xué)位論文 前1條

1 林玉琛;分體注吸在外傷性白內(nèi)障皮質(zhì)清除中的應(yīng)用[D];廣西醫(yī)科大學(xué);2007年

，

本文編號：1902700