| 玻璃体切割联合超声乳化人工晶状体巩膜层间固定治疗外伤性晶状体半脱位 |
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| 引用本文： | 孙新成,陈晨,贾砚文,卢国华,谢阳,潘婷.玻璃体切割联合超声乳化人工晶状体巩膜层间固定治疗外伤性晶状体半脱位[J].眼科新进展,2019,0(10):980-983. |
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| 作者姓名： | 孙新成 陈晨 贾砚文 卢国华 谢阳 潘婷 |
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| 作者单位： | 213003 江苏省常州市，南京医科大学附属常州市第二人民医院眼科 |
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| 摘 要： | 目的探讨玻璃体切割联合超声乳化人工晶状体巩膜层间固定术治疗外伤性晶状体半脱位的疗效。方法对2015年6月至2018年6月来我院就诊的保守治疗无效的外伤性晶状体半脱位12例患者采用囊袋拉钩辅助进行白内障超声乳化联合23G玻璃体手术处理半脱位晶状体,之后进行人工晶状体巩膜层间固定。对术前及术后视力、眼压、散光度等进行统计学分析,并对术后人工晶状体情况及手术并发症进行评估。结果12例12眼患者均顺利进行玻璃体切割联合超声乳化摘除脱位晶状体,同时行巩膜层间固定植入人工晶状体;术后3个月裸眼视力及最佳矫正视力均较术前提高显著,裸眼视力从治疗前0.14±0.12提高至治疗后0.44±0.17(t=-5.031,P<0.001);最佳矫正视力从治疗前0.29±0.17提高至治疗后0.57±0.15(t=-4.366,P<0.001);术前眼压为(28.30±8.87)mmHg(1kPa=7.5mmHg),术后3个月眼压为(14.70±3.47)mmHg,差异有统计学意义(t=4.94,P<0.05);术后3个月总散光度为(-1.35±0.73)D,角膜散光度为(-1.48±0.70)D,两者具有相关性(r=0.91,P<0.01)。术后1眼发生人工晶状体襻与光学区分离,取出人工晶状体再次使用相同方法治疗。术后3个月所有人工晶状体位置稳定,无偏心、扭曲等,术后眼前节炎症反应轻。结论玻璃体切割联合超声乳化人工晶状体巩膜层间固定术治疗外伤性晶状体半脱位效果较好,手术并发症少,值得在临床推广应用。
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| 关 键 词： | 外伤性晶状体半脱位 巩膜层间固定 玻璃体切割 超声乳化 |
Clinical observation of vitrectomy combined with phacoemulsification and intrascleral intraocular lens fixation in the treatment of traumatic lens subluxation |
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| SUN Xin-Cheng,CHEN Chen,JIA Yan-Wen,LU Guo-Hua,XIE Yang,PAN Ting.Clinical observation of vitrectomy combined with phacoemulsification and intrascleral intraocular lens fixation in the treatment of traumatic lens subluxation[J].Recent Advances in Ophthalmology,2019,0(10):980-983. |
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| Authors: | SUN Xin-Cheng CHEN Chen JIA Yan-Wen LU Guo-Hua XIE Yang PAN Ting |
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| Affiliation: | Department of Ophthalmology，the Second People’s Hospital of Changzhou Affiliated to Nanjing Medical University，Changzhou 213003，Jiangsu Province，China |
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| Abstract: | Objective To investigate the application of vitrectomy plus phacoemulsification and intrascleral fixation of intraocular lens in traumatic lens subluxation.Methods Retrosepctive observational study.Twelve patients (twelve eyes) with traumatic lens subluxation were included from the department of ophthalmology of Changzhou Second People’s Hospital between June 2015 and June 2018.All patients underwent phacoemulsification aided with capsular retractors and 23 gauge vitrectomy.Then intrascleral fixation of intraocular lens was done.The preoperative and postoperative visual acuity,intraocular pressure,postoperative astigmatism and other results were statistically analyzed,and the postoperative intraocular lens condition and surgical complications were evaluated.Results Twelve eyes of twelve patients were successfully treated with vitrectomy combined with phacoemulsification,and intraocular lens was implanted with scleral interlaminar fixation.The uncorrected visual acuity and the best corrected visual acuity were significantly improved after 3 months follow-up.The mean uncorrected visual acuity increased from 0.14±0.12 before treatment to 0.44±0.17 after treatment (t=5.031,P<0.001).The mean best corrected visual acuity increased from 0.29±0.17 before treatment to 0.57±0.15 after treatment (t=-4.366,P<0.001).The mean intraocular pressure was (28.3±8.87)mmHg (1 kPa=7.5 mmHg) before operation and (14.7±3.47)mmHg three months after operation.The intraocular pressure decreased significantly after operation compared with that before operation (t=4.94,P<0.05).Three months after operation,the total astigmatism ［(-1.35±0.73)D］ and the corneal astigmatism ［ (-1.48±0.70)D］ were significantly correlated (r=0.91,P<0.01).The intraocular lens loop was separated from the optical area in 1 eye,and the intraocular lens was removed and treated with the same method again.The position of intraocular lens was stable in 3 months after operation,and the other intraocular lens were stable without eccentricity,distortion.The inflammatory reaction of anterior segment was mild.Conclusion Vitrectomy combined with phacoemulsification and intrascleral fixation of intraocular lens was effective in traumatic lens subluxation patients with less surgery complication.Thus,it deserves clinical promotion. |
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| Keywords: | traumatic lens subluxation intrascleral fixation vitrectomy phacoemulsification |
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