有晶体眼后房型人工晶体植入术

有晶体眼后房型人工晶体植入是近年来发展起来的矫正中度和高度近视或远视的一项新技术,它具有矫正效率高,效果好,预测笥好,可逆性,保留功能和对角膜内皮损伤小的特点。随着人工晶体的改良和临床经验的积累,手术并发症也在逐渐减少。本文对该手术的人工设计,手术适应证与禁忌证,术前准备,手术技术,并发症及其防治等方面进行了综述。     

并发性白内障人工晶体植入术并发症的分析

并发性白内障人工晶体植入术并发症的分析第二军医大学长海医院眼科夏风华，李品娜我院在白内障后房型人工晶体植入术的基础上，近２年开展了并发性白内障人工晶体植入术４１只眼，取得了较为满意的效果。临床资料一般资料。本组共３５例４１眼，其中男性２８例３３眼，女...     

并发性白内障人工晶体植入术的初步报告

２４例２９只眼并发性白内障囊外摘出联合人工晶体樾主术后随访３个月￣３年（平均１６．４个月），裸眼眼力平均为０．３７１（０．００６￣０．７），≥０．０５者２６只眼（脱盲率８９．６５％）。术后视力较好的是不伴眼后段病变的虹膜睫状体炎并发性白内障，６只眼裸眼视力均≥０．５，平均可达０．６；其次是近视并发性白内障，５０％视力≥０．５；合并视神经视网膜、脉络 及玻璃体病变者效果稍差，但大多（８３．３３％）能     

色素膜炎并发性白内障行后房型人工晶体植入术

色素膜炎并发性白内障行后房型人工晶体植入术周宏健，魏爱民慢性色素膜炎的常见并发症即并发性白内障，可以手术治疗￣［１，２］。传统的手术方式是采用白内障囊内摘除。近１０年随着后房型人工晶体植入术的完善和推广，我院对一组色素膜炎并发性白内障患者施行现代囊外...     

并发性白内障后房型人工晶体植入

报告３２例，１１种并发性白内障后房型人工晶体植入，术后随访１－３０个月，平均６０％以上视力＞０．５。提示并发性白内障，只要原发性疾病得到控制，术中掌握技巧，手术是安全而有效的。因此从本组资料表明：并发性白内障后房型人工晶体植入基本无禁忌症。     

外伤性白内障人工晶体植入术后随访

外伤性白内障多伴有各种并发症,术后炎症反应重,常影响人工晶体植入及术后视力矫正和双眼视功能.我院从1992年1月至1993年6月共收治外伤性白内障73例,其中行白内障囊外摘除和Ⅰ期后房型人工晶体植入共26例27眼,现报告如下:l、一般资料:男24例25眼,女2例2眼;双眼1例,右眼9例,左眼16例.年龄最小4岁,最大53岁,平均20.16岁,12岁以下6眼.2、外伤性质和并发症:眼球穿通伤24眼,其中角膜穿通伤23眼,巩膜穿孔伤1眼,角膜穿孔伤伴眼内金属异物3眼,(晶体异物1眼,玻璃体异物2眼),电击伤2眼,铝水灼伤1眼.角膜瞳孔区严重损伤7眼,周边部损伤17眼.虹膜损伤致瞳孔变形9眼,晶体前囊破裂13眼,术中发现晶体后囊破裂8眼.     

白内障囊外摘出及后房型人工晶体植入术

报道了３０例（３５只眼）后房型人工晶体植入术的远期效果，经１～７年随访，获得良好视力，一般在０．３～１．５之间，视力为０．５及以上者占９１．４３％，矫正视力１．０～１．５者占８２．８６％，并发症少，效果稳定。     

无虹膜眼人工晶体植入术的探讨

现代囊外摘除及后房型人工晶体植入现已成为白内障治疗的常规手术.而在外伤性白内障,人工晶体植入更有其特殊意义.因为外伤性白内障大多为单眼白内障,为了术后保持良好的双眼单视和立体视功能,人工晶体植入几乎是唯一的选择.然而严重的眼外伤常导致虹膜的损伤,甚至形成完全性无虹膜.无虹膜眼进行人工晶体植入,在一个时期曾被认为是手术的禁忌证.这是由于人工晶体袢无法在睫状沟牢固地固定,又无虹膜作为人工晶体光学部分的前方依托.囊袋内人工晶体植入虽然解决了无膜眼人工晶体的固定问题,但早年采用开罐式截囊,留下了锯齿状边缘,常因此而在娩出晶体核时或植入人工晶体时,引起晶体囊撕裂,重者可达赤道部.从而可使人工晶体移位,倾斜甚至脱位.连续圆形撕囊法使前囊的孔光滑无缺口,     

外伤性白内障人工晶体植入术102眼临床观察

目的 探讨外伤性白内障摘除人工晶体植入术的手术时机、手术方式及并发症的治疗。方法１０２例（１０２眼）均行后房型人工晶体植入,４８眼伴虹膜粘连,１２眼伴前房及晶体异物,４眼伴玻璃体腔磁性异物,２眼伴继发性青光眼,共６６眼在处理相关病变同时Ｉ期植入后房型人工晶体;３眼晶体脱位和６眼后囊破裂范围大于一个象限患者行Ｉ期巩膜缝线固定人工晶体植入术;８眼严重角巩膜裂伤和１０眼明显玻璃体混浊,先处理相应病变,为     

有晶状体眼后房型人工晶状体植入术后并发性白内障的研究进展

随着现代屈光手术的不断进步,有晶状体眼后房型人工晶状体(implantable contact lens,ICL)植入术作为一种屈光不正的矫正方法正逐渐被人们所接受.ICL植入术后并发性白内障发生率约2％～3.5％,严重时需白内障手术(＜1％).ICL植入术后早期并发性白内障与手术操作、患者年龄及屈光度等有关,而晚期并...     

有晶状体眼后房型人工晶状体植入术治疗高度近视的护理

目的:探讨在有晶状体眼后房型人工晶状体(implantable collamer lensi mplantation,ICL)植入术治疗高度近视时,护理对手术效果及安全性的影响。方法:对103例206眼高度近视患者行有晶状体眼ICL植入术的心理护理、术前准备、术中及术后护理进行总结。结果:所有患者视力明显提高,满意度良好。医护间的配合、合理的心理护理使患者术前主动配合治疗;有效的术后护理和必要的出院指导,可密切观察病情变化,调整治疗方案,使患者得到更好的术后治疗效果。结论:医护之间的配合、有效的护理和以患者为中心的服务理念对提高有晶状体眼ICL植入术的手术效果和安全性具有重要意义。     

中央孔型眼内镜植入术后拱高的影响因素

目的 探讨中央孔型眼内镜（ICL）植入术后中央拱高的影响因素及分析导致极端拱高的可能原因。设计 回顾性病例系列。研究对象 2018-2019年北京同仁眼科中心接受V4c型ICL植入术的患者138例（276眼）。方法 回顾患者术前眼部生物测量参数包括屈光度（SE）、角膜水平直径即白到白（WTW）、前房深度（ACD）、前房容积（ACV）、前房角（Angle）、眼轴长度（AL）、晶状体厚度（LT）及术中植入ICL的直径。术后1周用眼前节OCT测量患者的拱高（Vault）。采用多元逐步回归分析确定拱高值和眼部生物参数的相关性。按拱高大小分为三组,分别为低拱高组（＜250 μm）、正常拱高组（250~1000 μm）和高拱高组（>1000 μm）,对三组间眼部参数进行比较,分析造成极端低拱高和极端高拱高的可能影响因素。主要指标 术后拱高值。结果 术后1周平均拱高为（645±247）μm。多元逐步回归分析得到拱高的回归方程为：Vault（μm）=180.954×ACD(mm) +99.805×WTW（mm）-2517.5,调整r2为0.069。低拱高组、正常拱高组、高拱高组三组间的ICL直径（127.9±3.8 mm、127.3±3.6 mm、130.2±2.8 mm）和ACD（2.95±0.29 mm、3.19±0.24 mm、3.29±0.22 mm）均有统计学差异（P均＜0.05）;年龄、SE、Angle、ACV、WTW、CCT、K1、K2差异无统计学意义（P均>0.05）。结论ACD和WTW是影响术后拱高的关键因素。同时,晶状体偏厚是极端拱高的可能影响因素。提示在临床上遇到非年龄性晶状体偏厚者,在ICL的选择上需要综合考虑更多因素。     

有晶状体眼后房型人工晶状体植入术后视觉质量及并发症的研究进展

角膜屈光手术和有晶状体眼后房型人工晶状体(ICL)植入术是目前的主流屈光手术方式。众多研究证明ICL植入术能有效提高患者的术后视力,因此受到越来越多屈光医生和患者的青睐。良好的术后视力及视觉质量是提高患者满意度的关键因素。为了评估患者术后的主观及客观视觉质量、预防并发症的发生,本文对ICL植入术后的视觉质量及术后并发症进行综述。     

高度近视眼后房型ICL植入术后波前像差的改变

目的:观察高度近视眼有晶状体眼后房型人工晶状体植入后全眼及眼内波前像差的变化。方法:选择行有晶状体眼人工晶状体(implantable collamer lens,ICL)植入术的高度近视眼患者25例50眼,用尼德克波前像差仪测量患者6mm瞳孔区域内术前和术后1mo的波前像差值,对其进行配对t检验。结果:ICL植入眼术后1mo全眼总体波前像差(OPDTotal)、眼内总体波前像差(Internal Total)较术前明显下降(P<0.05)。全眼总体高阶波前像差(OPD High)、全眼总体球面像差(OPDT.SPH)、全眼总体彗差(OPDT.Coma)、全眼总体三叶草(OPDT.Trefoil)、眼内总体彗差(Internal T.Coma)较术前有不同程度升高,具有统计学意义(P<0.05)。角膜总体波前像差(C-Total)、角膜总体高阶波前像差(C-High)、角膜球差(C-T.Sph)、角膜彗差(C-T.Coma)、角膜四叶草(C-T.4Foil)较术前有不同程度升高,角膜三叶草(C-T.Trefoil)较术前明显下降,但差异均无统计学意义。结论:有晶状体眼后房型人工晶状体植入术虽然显著降低了高度近视眼的总体波前像差,但术眼球面像差、彗差、三叶草等高阶波前像差有不同程度增加。     

ICL V4c植入术后远期疗效的研究进展

随着科技的快速发展与电子产品的广泛应用,高度近视患者的数量逐渐增加。同时,由于手术技术的持续优化和后房型人工晶状体材料以及制造工艺的不断进步,ICL V4c植入术已逐渐成为治疗高度近视的主要手术方式之一。在步入社会信息化的高速时代,人们对ICL V4c植入术后的远期疗效更加关注。不仅希望视力清晰,更追求视觉的舒适度与持久性。因此,本文将特别针对近3 a内至少有2 a跟踪观察的ICL V4c植入术后疗效的研究进展进行详细探讨,旨在从ICL V4c植入术后的视觉质量,手术的安全性、有效性、稳定性,以及可能出现的手术并发症这三个维度对ICL V4c植入术后远期疗效的最新研究进展进行综述。     

Clinical observations of iridociliary cysts and their changes after implantable collamer lens implantation in myopic patients

AIM: To analyze the clinical efficacy of the partial rectus muscle transportation (PRT) procedure for paralytic strabismus due to single rectus muscle palsy. METHODS: In total, 28 patients (31 eyes) who underwent the PRT procedure for paralytic strabismus due to single rectus muscle palsy were retrospectively examined. The following data were collected pre- and postoperatively: angle of deviation in the primary position, presence of diplopia in the primary position, presence of compensatory head posture, and motility of the affected eye. The follow-up period was 6mo. RESULTS: Based on the preoperative and intraoperative findings, different operations were performed: 2 eyes were treated with PRT, 26 eyes were treated with PRT combined with the recession of the antagonist muscle (Am) of the paralytic rectus muscle, and 3 eyes were treated with PRT along with the recession of the Am and the yoke muscle (Ym). On the first day after the operation, 24 patients were found to be orthophoric in the primary position, without diplopia or abnormal head posture. Moreover, 2 patients with monocular lateral rectus muscle palsy had mild overcorrection to 5 prism diopters (PD) and 8 PD, respectively, whereas 2 patients with binocular lateral rectus muscle palsy had mild undercorrection to 8 PD and 10 PD, respectively. During the 6-month follow-up period, the mean deviation was rectified from 96.79±41.21 PD to 0.64±2.38 PD (t=12.48, P<0.001), whereas the deviations in the 2 patients with mild overcorrection were corrected to orthotropia. The mean preoperative limitation of motility improved from -4.55±0.51 to -2.65±0.61 (t=-15.13, P<0.001) after 6mo postoperatively. CONCLUSION: PRT is an effective treatment for complete paralytic strabismus due to single rectus muscle palsy, and can achieve stable clinical efficacy.     

The effects of implantable collamer lens implantation on higher order aberrations

AIM: To evaluate the changes in higher order aberrations (HOAs) after implantable collamer lens (ICL; Staar Surgical, Nidau, Switzerland) implantation. METHODS: Totally 30 eyes of 18 patients with myopia were included in this study with an average age of 25.77y (min: 21, max: 40). Refraction, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), HOAs (entire, corneal and internal) were evaluated preoperatively and three months postoperatively. Ocular aberrations were measured by using iTrace (Tracey Technology, Houston, Texas, USA). SPSS (IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp) was used for the statistical analysis and the interpretation of the data. P values of less than 0.05 were considered statistically significant. RESULTS: The preoperative mean spherical power was -9.01 D (min: -5.00, max: -13.00) and the mean cylindrical error was -2.40 D (min: -0.50, max: -4.75). The postoperative mean residual spherical power was -0.73 D (min: -0.20, max: -1.75) and the mean cylindrical error was -0.89 D (min: -0.18, max: -2.09). Analyses were made on root mean square (RMS) values of total HOAs (tHOAs), spherical aberration, coma and trefoil as entire, corneal and internal components. The differences in entire tHOAs and in internal tHOAs were significant. There was no significant change found in spherical aberrations. The differences in entire coma and in internal coma were significant. There was no significant change found in corneal coma. With respect to trefoil, the only significant difference was in internal trefoil. CONCLUSION: The ICL implantation corrects the refractive error successfully and changes entire and internal HOAs of the eye.     

Clinical prediction of insufficient vaults after implantable collamer lens implantation

AIM: To determine the factors related to preoperative ocular characters that are predictive of insufficient vault (<250 μm) after implantable collamer lens (ICL V4c; STAAR Surgical) implantation. METHODS: The participants underwent ICL surgery and were divided into the low (<250 μm) and normal (250-1000 μm) vault groups based on the postoperative vault at 3mo. The preoperative biometric parameters and clinical outcomes were compared between the two groups. The relationship between the 3-month vault values and preoperative ocular parameters were evaluated by Generalized estimating equations. RESULTS: Sixteen (23 eyes) and 36 patients (63 eyes) were in the low and normal vault groups, respectively. All implantation procedures were uneventful with no cataract formation in the early postoperative period. The sulcus-to-sulcus lens rise (STSL) and iris ciliary angle (ICA) were correlated with vault at 3mo after surgery. Every 0.1 mm increase in STSL was associated with 38.9 μm decrease in the postoperative 3-month vault. A rise of 1 degree in ICA is associated with a reduction of 4 μm in vault. CONCLUSION: Eyes with a narrow ciliary sulcus are associated with a higher rate of low vault after ICL implantation, suggesting a need for adjustments to the ICL size in these patients. Evaluating the characteristics of the ciliary sulcus contributes valuable information to predict low vault after surgery.     

有晶状体眼后房型人工晶状体植入术后早期拱高影响因素分析

目的：观察有晶状体眼后房型人工晶状体(ICL/TICL V4c)植入术后拱高的早期变化趋势并分析相关影响因素。

方法：回顾性研究。选取2020-10/2021-03于兰州华厦眼科医院接受ICL/TICL V4c植入术患者49例98眼。收集患者术前等效球镜度数(SE)、眼压、眼轴、前房深度(ACD)、晶状体厚度(LT)、中央角膜厚度、前房角(ACA)、前房容积(ACV)、角膜白到白直径(WTW)、平均角膜曲率K1、K2,术中植入的ICL尺寸,术后1、3d,1wk,1mo用AS-OCT测量患者拱高(vault)。按术后1mo拱高值大小分为低拱高组(<250μm)12眼、正常拱高组(250～750μm)62眼、高拱高组(>750μm)24眼,分析影响术后拱高的因素。

结果：术后1、3d,1wk,1mo平均拱高值分别为591.05±293.44、599.62±309.78、592.22±301.49和586.69±285.63μm。术后1mo不同拱高间WTW、ACA、ACV、ACD、ICL尺寸、LT有差异(均P<0.05)。术后1mo拱高的回归方程=-3142.19+388.25×WTW+10.40×ACA-301.63×LT,R、R²、调整R²分别为0.674、0.454、0.436。WTW对术后1mo拱高影响最大(β=0.47,P<0.001),其次为LT(β=-0.34,P<0.001)和ACA(β=0.17,P=0.047)。

结论：WTW、ACA、LT是影响和预测ICL/TICL V4c植入术后1mo拱高的主要因素。